Tuberculous meningitis with multiple intracranial tuberculomas mimicking neurocysticercosis clinical and radiological findings.
Central nervous system (CNS) tuberculosis (TB), the most dangerous form of TB, remains a public health problem, particularly in developing countries. In the differential diagnosis of intracranial tuberculomas (ICTs), images on radiological findings should be differentiated from other causes of space-occupying lesions. These lesions include malignant diseases such as glioma or lymphoma, pyogenic abscess, toxoplasmosis, neurocysticercosis (NC), sarcoidosis, hydatidosis and late syphilitic involvement of CNS. We present a case with multiple ICTs mimicking NC with similar clinical and imaging manifestations in a young immunocompetent patient. The diagnosis was based on brain magnetic resonance imaging findings. The definitive diagnosis was confirmed mycobacteriologically in cerebrospinal fluid and sputum specimens. Adequate response to anti-TB chemotherapy was achieved while multiple ICTs in the brain disappeared slowly. In the absence of appropriate therapy, these pathologies might be fatal; the possibilities of differential diagnosis would be of great clinical importance, particularly because of the different treatment protocols required for the NC and ICTs.
Oncul
Oral
O
Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey. robertcool@graffiti.net
Baylan
Orhan
O
Mutlu
Hakan
H
Cavuslu
Saban
S
Doganci
Levent
L
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D020019:Neurocysticercosis / Q000175:diagnosis* / Q000473:pathology*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*
D000995:Antitubercular Agents