Jpn. J. Infect. Dis., 58 (6), 387-389, 2005
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Short Communication
Tuberculous Meningitis with Multiple Intracranial Tuberculomas Mimicking Neurocysticercosis Clinical and Raidiological Findings
Oral Oncul*, Orhan Baylan1, Hakan Mutlu2, Saban Cavuslu and Levent Doganci1
Department of Infectious Diseases and Clinical Microbiology and 2Department of Radiology, Gulhane Military Medical Academy haydarpasal Trainng Hospital, Istanbul and 1Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy, Ankara, Turkey
(Received July 21, 2005. Accepted October 12, 2005)
*Corresponding author: Mailing address: Department of Infectious Diseases and Clinical Microbiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, 34670, Uskuda-Istanbul, Turkey. Tel: +90 216 542 24 58, Fax: +90 216 348 78 80, E-mail: robertcool@graffiti.net
SUMMARY: 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.