Brainstem tuberculoma in a postpartum patient

Akhaddar, Ali; Mahi, M.; Harket, Anass; Elmostarchid, Brahim; Belhachemi, A.; Elasri, Abad; Gazzaz, Miloudi; Boucetta, Mohamed

doi:10.1016/j.neurad.2007.09.001

Cited by 15 publications

(8 citation statements)

References 4 publications

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“…However, musculoskeletal and focal neurological infections can rarely be seen in the postpartum period. [2316] Among them, PPA is uncommon. Few cases have been previously reported in postpartum patients, typically following normal vaginal delivery or cesarean section [Table 1].…”

Section: Discussionmentioning

confidence: 99%

“…[1519] On the other hand, alterations to the immune status during pregnancy can lead to impaired cell-mediated immunity with an increased susceptibility to certain infections such as tuberculosis. [3] Our patient had no known history suggesting a malignancy or dysfunctional immunity. In addition, it is unclear as to how a woman who was healthy previously could develop such a potentially serious complication after an apparently uncomplicated vaginal delivery.…”

Section: Discussionmentioning

confidence: 99%

“…Tubercular lesions must be treated with the appropriate antituberculous regimens. [13] Drainage of the suppurative abscess collection may be either surgically or under radiological guidance. Percutaneous drainage is much less invasive than open surgical drainage and is appropriate for draining uniloculated and multiloculated abscesses with few septations as was the case in our patient.…”

Section: Discussionmentioning

confidence: 99%

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Primary tuberculous psoas abscess as a postpartum complication: Case report and literature review

et al. 2018

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Background:Primary psoas abscess is an unusual clinical entity rarely encountered in the postpartum period. Only seven cases have been reported to date. Here, we present a woman with a primary psoas abscess caused by Mycobacterium tuberculosis and occurred 2 months following a normal vaginal birth. We highlight the difficulties in the management of this uncommon condition in light of the relevant literature.Case Description:A 34-year-old woman who was previously healthy was presented at 2 months’ postpartum with important right sciatica and low back pain without fever. Examination of the abdomen revealed tenderness in the right iliac fossa but obstetric/gynecologic and neurologic examinations were normal. The patient had an elevated C-reactive protein level and computed tomography (CT)-scan demonstrated a large psoas abscess on the right side without sacroiliac or spine abnormalities. Initial posterior lumbar percutaneous drainage was useful, but no pathogens were identified. The patient was discharged home with oral antibiotics therapy (amoxicillin/clavulanate and metronidazole). Four weeks later, the follow-up CT-scan showed a re-accumulation of the abscess cavity. Subsequently, the patient underwent a right anterolateral laparotomy with a retroperitoneal approach for abscess drainage. Again, no microorganisms were found. However, diagnosis of tuberculosis was established on histopathologic study. She was successfully treated with antituberculous drugs with a good outcome.Conclusions:Most primary psoas abscesses present with a delay in diagnosis because of the rarity of this infectious disease, the lack of specific symptoms and signs, and its similarity to many differential diagnoses. When suspected, CT-scan and/or magnetic resonance imaging help in making an accurate diagnosis and facilitate percutaneous or open surgical drainage of the abscess. Correct and fast identification of the microorganisms in addition to appropriate usage of antibiotic regimen improves the outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary tuberculous psoas abscess as a postpartum complication: Case report and literature review

et al. 2018

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“…The incidence of coexistent CNS tuberculoma and tuberculous meningitis is between 10% and 50%. [46] Tuberculomas are primarily located in the cerebral hemisphere, although tuberculomas have been found in the pituitary stalk,[1] sellar and suprasellar regions,[789] corpus callosum,[10] cavernous sinus,[111213] brainstem,[1415161718] cerebellum[1920] and intraventricular. [212223] Intraventricular tuberculomas are rare, and, among them, third ventricular tuberculoma is very rare; only one case has been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Third ventricular tuberculoma mimicking as a tumor: Report of a very rare case

Sharma¹,

Kaushal²,

Vaidya³

et al. 2017

Asian J Neurosurg

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Intracranial tuberculoma is a common neurosurgical problem in developing countries; however, intraventricular tuberculoma is a rare entity. Here, we report a rare case of third ventricular tuberculoma in a 21-year-old girl who presented with features of raised intracranial pressure. Radiological findings and management of third ventricular tuberculoma would be discussed and literature regarding such lesions will be reviewed.

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“…74,75 In contrast to conventional wisdom, clinical findings are usually not suggestive of infection, ie, in most cases there is no fever, signs of meningismus, or leukocytosis. [74][75][76][77] Consequently, patient symptoms generally result from affected BS nuclei and/or tracts. Because abscesses in the BS are most frequently located in the pons, cranial nerves VI and VII are most frequently involved.…”

Section: Abscessmentioning

confidence: 99%

Differential Diagnosis of T2 Hyperintense Brainstem Lesions: Part 1. Focal Lesions

Guzmán-De-Villoria

Fernández-García

Ferreiro-Argüelles

2010

Seminars in Ultrasound, CT and MRI

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Brainstem lesions can be classified as focal or diffuse. Magnetic resonance imaging is the most suitable imaging modality for evaluating these lesions. As a rule, focal lesions are not large and have well-defined margins. Causes include tumors, vascular malformations, demyelinating diseases, brain abscesses, hypertrophic olivary degeneration, and dilated Virchow-Robin spaces. Differential diagnoses of these numerous entities mandates a review of magnetic resonance imaging findings in conjunction with epidemiologic aspects, clinical features, and other medical test results.

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Brainstem tuberculoma in a postpartum patient

Cited by 15 publications

References 4 publications

Primary tuberculous psoas abscess as a postpartum complication: Case report and literature review

Primary tuberculous psoas abscess as a postpartum complication: Case report and literature review

Third ventricular tuberculoma mimicking as a tumor: Report of a very rare case

Differential Diagnosis of T2 Hyperintense Brainstem Lesions: Part 1. Focal Lesions

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