Infect Chemother.  2008 Dec;40(6):323-326. 10.3947/ic.2008.40.6.323.

A Case of Disseminated Tuberculosis with Miliary Central Nervous System Tuberculoma

• Noh JY
• Heo JY
• Lee KG
• Yoon YK
• Lee J
• Song JY
• Cheong HJ
• Kim WJ

• KMID: 1782298
• DOI: http://doi.org/10.3947/ic.2008.40.6.323

Abstract

Disseminated tuberculosis occurs through lymphohematogenous dissemination of Mycobacterium tuberculosis bacilli. The exact incidence of disseminated tuberculosis is still unknown and its diagnosis presents a challenge since the symptoms are not specific of the disease. Brain tuberculoma is one of the complications of tuberculosis. The literary review of brain tuberculoma shows that it mainly occurs in the cerebrum and cerebellum, whereas involvement of the brainstem is rare. Recently, we have experienced a case of 46-year-old man with fever of 2 months duration who was diagnosed with disseminated tuberculosis with miliary central nervous system (CNS) tuberculomas; brain tuberculomas were found even in the brainstem and the spinal cord. Pulmonary, intestinal, renal, and choroidal involvements were also noted.

Keyword

Miliary tuberculosis; Tuberculoma; Fever of unknown origin

MeSH Terms

Brain
Brain Stem
Central Nervous System
Cerebellum
Cerebrum
Choroid
Fever
Fever of Unknown Origin
Humans
Incidence
Middle Aged
Mycobacterium tuberculosis
Spinal Cord
Tuberculoma
Tuberculosis
Tuberculosis, Miliary

Figure

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  Figure 1 Miliary nodules were observed in both lung fields.

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  Figure 2 Numerous small nodular or ring enhanced lesions were noted in cerebrums, cerebellums, brainstem, and upper cervical spinal cord, suggesting tuberculomas on the T1 weighted MRI.

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  Figure 3 Multiple choroidal tuberculomas were noted in both eyes by the indirect ophthalmoscopy.

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