Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient.
Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion) who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis was reached. However, a trial with first-line antituberculous drugs led to a significant clinical and radiological improvement. Atypical presentations of cerebral tuberculomas should always be considered in the differential diagnosis of intracranial mass lesions in HIV-infected patients and a trial with antituberculous drugs is a valuable strategy to infer the diagnosis in a subset of patients.
Department of Infectious Diseases, Institute of Infectious Diseases Emilio Ribas, São Paulo, SP, Brazil.
Daniela
D
Pellegrino
Juliana
J
Gerhardt
Fátima M V
FM
Porfírio
Edgar de Bortholi
Ede B
Santos
Rafi F
RF
Dauar
Augusto C Penalva de
AC
Oliveira
José E
JE
Vidal
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000188:drug therapy*
D000995:Antitubercular Agents