title: Intracranial tuberculomas in adults: a report of twelve consecutive patients in Houston, Texas.
abstract: BACKGROUND
  Intracranial tuberculomas are rare manifestations of tuberculosis (TB). An extensive literature review revealed that no study of consecutive adults with intracranial tuberculoma has been conducted in the USA.
  
  
  METHODS
  This retrospective study consisted of 12 adults consecutively identified with intracranial tuberculomas from 1995 to 2009 in Houston, Texas. Of the 12 cases, 8 had a histopathological diagnosis, while 4 had a probable diagnosis based on the following criteria: (1) Mycobacterium tuberculosis identified from a source outside the brain, (2) radiographic confirmation of an intracranial mass, (3) received chemotherapy with 2 or more anti-tuberculosis medications, and (4) clinical response at 1-y follow-up.
  
  
  RESULTS
  Common clinical manifestations were altered mental status, fever, and night sweats. Four patients (25%) had a human immunodeficiency virus (HIV) infection. Nine patients (75%) had concomitant M. tuberculosis at at least 1 extracranial site, including 5 patients with pulmonary TB. The median duration of therapy was 11 months. Patients had a 1-y mortality rate of 16.7% and an overall morbidity rate of 20%.
  
  
  CONCLUSIONS
  Intracranial tuberculomas in Houston, Texas, are rare. Hospital discharge predicted survival at 1 y, despite severe clinical presentations and invasive diagnostic procedures. However, tuberculoma cases are associated with higher mortality rates than non-central nervous system TB cases.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas 77030, USA. jdkelly@bcm.edu
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Kelly
authors.forename: Larry D
authors.initials: LD
authors.lastname: Teeter
authors.forename: Edward A
authors.initials: EA
authors.lastname: Graviss
authors.forename: David J
authors.initials: DJ
authors.lastname: Tweardy
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000995:Antitubercular Agents / Q000627:therapeutic use; D001921:Brain / Q000382:microbiology / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000166:cytology / Q000382:microbiology; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D013781:Texas; D016862:Tuberculoma, Intracranial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents