Images in Clinical Medicine
Cerebral Tuberculoma
N Engl J Med 2007; 357:2166November 22, 2007
- Article
A 29-year-old homeless man was admitted to the hospital after being stabbed in the chest. A hemothorax was diagnosed, and a chest tube was placed. One day after admission, he had a generalized tonic–clonic seizure. He was afebrile and had no meningeal signs but had left hemiparesis and hyperreflexia. On questioning, he reported having had increased weakness on the left side during the preceding year. Magnetic resonance imaging of the head with the administration of gadolinium showed a ring-enhancing mass in the right parietal lobe (Panels A and B, arrows). This was interpreted as a central nervous system neoplasm, and a resection was performed. Histologic examination showed caseous necrosis with multinucleated giant cells and acid-fast bacillae. A test for human immunodeficiency virus was negative, and no evidence of pulmonary disease was found. The patient was started on four antituberculosis medications and was discharged 2 weeks after admission. At a follow-up visit, his stab wound had healed without sequelae, but he had persistent hemiparesis on the left side.
Juan Carlos Cataño, M.D.
University of Antioquia Medical School, Medellin, Colombia
kataju@hotmail.com - Citing Articles (1)
Citing Articles
1
A. Botturi, E. Prodi, A. Silvani, P. Gaviani, G. Vanoli, A. Carbone, A. Salmaggi. (2011) Brain tuberculoma (Mycobacterium africanum): high index of suspicion helps in avoiding biopsy/surgery. Neurological Sciences
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