Multiple Intracranial Tuberculomas: A Rare Case of CNS TB

Agus Nur Salim Winarno

Abstract

Tuberculosis (TB) is still to be worlds major health concern. About 8,6 million cases occur in 2012 worldwide. TB doesnt mainly affect the lungs but it can affect extra pulmonary system. Central nervous system (CNS) is one complication of TB that should be considered as it is associated with high morbidity and mortality. Tuberculoma is one form of CNS TB that is rare and challenging in diagnostic. It will be presented a case of adult female with history of on-going TB treatment that presents with altered mental status, focal neurological signs, and increased ICP signs and symptoms. The head CT with contrast shows multiple ring enhancement with perilesional edema that consistent with brain tuberculoma. She was admitted to ICU and she got anti-TB drugs, and systemic steroid.

Keywords

Tuberculosis; CNS TB; Tuberculoma

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References

Sulis G, Alberto R, Alberto M, Mario CR. Tuberculosis: Epidemiology and control. Mediterranean Journal of Hematology and Infectious Diseases. 2014;6(1):e2014070.

World Health Organization. Global tuberculosis report 2016 [Internet]. 2016. Available from: http://www.who.int

Singer-Leshinsky S. Pulmonary tuberculosis: Improving diagnosis and treatment. American Academy of Physician Assistants. 2016;29(2):20–5.

Vidal JE, Adrian VH, Augusto CPO, Alexandre LS, Geraldine M, Paula RMS, et al. Cerebral tuberculoma in AIDS patients: A forgotten diagnosis? Arquivos de Neuro-Psiquiatria. 2004;62(3–B):793–6.

Monteiro R, Jose CC, Claudia C, Raquel D. Cerebral Tuberculomas- A clinical challenge;9:. http://dx.doi.org/. Respiratory Medicine Case Reports. 2013;9:34–7.

Malhotra A, Mini M. Giant cerebral tuberculoma in pregnancy: Review of literature discussion. International Surgery Journal. 2016;3(1):386–9.

Chattarjee S. Brain Tuberculomas, Tubercular meningitis, and post-tubercular hydrocephalus in children. Journal of Pediatric Neurosciences. 2011;6(1):S96–100.

Kim TK, Kee HC, Chong JK, Jin MG, Myeong CK, Moon HH. Intracranial tuberculoma: Comparison of MR with pathologic findings. American Journal of Neuroradiology. 1995;16(9):1903–8.

Idris MNA, Sokrab TEO, Arbab MAR, Ahmed AEM, El-Rasoul H, Ali S, et al. Tuberculoma of the brain: A series of 16 cases treated with anti-tuberculosis drugs. International Journal of Tuberculosis and Lung Disease. 2007;11(1):91–5.

Patnaik A, Sudhansu SM, Satya BS. Surgical management of double giant Tuberculomas of brain involving both supratentorial and infratentorial compartments. Journal of Pediatrics Neurosciences. 2013;8(1):84–5.

Banderas ME, Perez GV, Alonso MR, Ruiz MJ, De Pablo GA. Cerebral tuberculoma in a lung transplant patient.Journal of Microbial & Biochemical Technology;7(5):2015;7(5):244–7.

Rajakaruna PDG. Cerebral tuberculoma;61:922. Thorax. 2006;61(10):922.

Ashok-Kumar EA, Jijiya-Bai P. Clinical Study of CNS Tuberculomas. International Archives of Integrated Medicine. 2016;3(6):101–6.

Saleh M, Ali AS, Ali AP. Brain Tuberculomas: A case report. Jundishapur Journal of Microbiology. 2014;7(7):e11252.