title: Isolated intracranial infection with Mycobacterium avium complex.
abstract: Mycobacterium avium-M. complex (MAC) has been linked to devastating respiratory and systemic illnesses in patients, especially in those who are immunosuppressed. The purpose of this study is to describe a case of isolated central nervous system (CNS) infection with MAC. This is a single case report of a patient with isolated intracranial mycobacterial infection.
  
  
  METHODS
  the patient was treated and the immunohistochemical investigations were undertaken at the National Institutes of Health in Bethesda, Maryland, USA.
  
  
  METHODS
  the patient initially was treated with a cocktail of antimycobacterial medications. However, because his disease was refractory, he underwent a suboccipital craniotomy and evacuation of his cerebellar mass. The patient was determined to have a low production of interferon-gamma (INF-gamma) and tumor necrosis factor-alpha (TNF-alpha) when compared to normal values. Despite extensive radiographic imaging studies and biopsies, there was no evidence of another focus of MAC infection in this patient. We conclude that intracranial infectious lesions in patients such as ours should be treated with conventional systemic antibiotic regimens as the first-line of therapy. We suggest neurosurgical intervention in medically refractory cases of intracranial infections.
authors: Department of Neurosurgery, Long Island Jewish Hospital, New Hyde Park, NY 11004, USA. drrdd@yahoo.com
authors: R D
authors: RD
authors: Dickerman
authors: Q E
authors: QE
authors: Stevens
authors: R
authors: R
authors: Rak
authors: S E
authors: SE
authors: Dorman
authors: S M
authors: SM
authors: Holland
authors: T T
authors: TT
authors: Nguyen
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002531:Cerebellum / Q000382:microbiology / Q000473:pathology*; D003399:Craniotomy; D006801:Humans; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000097:blood; D008279:Magnetic Resonance Imaging; D008297:Male; D015270:Mycobacterium avium-intracellulare Infection / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma