title: Clinicopathological study of tuberculous brain abscess.
abstract: Central nervous system tuberculosis is still one of the leading causes of morbidity in the developing world, and tuberculous abscess is one of its uncommon manifesting forms. It closely mimics a pyogenic abscess clinically, radiologically, and histologically. An accurate diagnosis is imperative due to therapeutic implications. In this study, 21 cases of tuberculous abscesses encountered over a period of 13 years (1995-2007) were reviewed to study the clinical, radiological, and histopathological spectrum of the disease. The presence of palisading epithelioid cells and sheets of foamy histiocytes, enclosing a neutrophillic exudate rich in fibrin with nuclear debris, were clues as to suspicion of a tuberculous abscess. The demonstration of acid fast bacilli in the wall of the abscess or necrotic contents by microscopy or culture is essential to confirm the diagnosis of tuberculous abscess. A high index of clinical suspicion is necessary particularly in countries endemic for tuberculosis to ensure an accurate diagnosis and application of an appropriate therapy.
authors.affiliation: Department of Neuropathology, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
authors.forename: Shrijeet
authors.initials: S
authors.lastname: Chakraborti
authors.forename: Anita
authors.initials: A
authors.lastname: Mahadevan
authors.forename: Aparna
authors.initials: A
authors.lastname: Govindan
authors.forename: S
authors.initials: S
authors.lastname: Nagarathna
authors.forename: Vani
authors.initials: V
authors.lastname: Santosh
authors.forename: T C
authors.initials: TC
authors.lastname: Yasha
authors.forename: B Indira
authors.initials: BI
authors.lastname: Devi
authors.forename: B A
authors.initials: BA
authors.lastname: Chandramouli
authors.forename: Jerry M E
authors.initials: JM
authors.lastname: Kovoor
authors.forename: A
authors.initials: A
authors.lastname: Chandramuki
authors.forename: S K
authors.initials: SK
authors.lastname: Shankar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D015622:Epithelioid Cells / Q000473:pathology; D005260:Female; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009336:Necrosis; D009504:Neutrophils / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult