Intraventricular tuberculosis abscess in an immunocompromised patient: clinical vignette

Abstract

Tuberculosis is caused by Mycobacterium tuberculosis. Tuberculosis of the central nervous system is common and manifestations include meningeal and intraparenchymal diseases. However, intraventricular tuberculous abscess is a rare manifestation of intracranial tuberculous infection. We present a case of an immunocompromised female patient with high-grade fever and signs of meningism. The computed tomography and magnetic resonance imaging (MRI) of the brain showed hydrocephalus with rim-enhancing lesion in the right lateral ventricle. The MRI demonstrated a hypointense signal on T1-weighted imaging, hyperintense signal on T2-weighted imaging, and mild restricted diffusion in diffusion-weighted imaging. She underwent emergency external ventricular drainage and frank pus was drained. Diagnosis of tuberculosis was made via polymerase chain reaction analysis and culture. Understanding the intracranial manifestation of neurotuberculosis is imperative to arrive at the diagnosis correctly and ensure prompt treatment.

Tuberculosis intestinal y talasemia: una asociación inusual. A propósito de un caso

“…Se revisaron casos descritos en la literatura colombiana, y se encontró una presentación extrapulmonar con compromiso en el sistema nervioso central (27) , pericardio con taponamiento cardíaco como primera manifestación (28) , esternón (29) en población pediátrica y un caso de un paciente con diabetes mellitus y talasemia e infección por TB pulmonar con múltiples coinfecciones asociadas (30) . En nuestro conocimiento, el caso presentado es el primer reporte de paciente con talasemia y TB diseminada, consideramos que se sienta un precedente relevante para futuras investigaciones, así como la ampliación de diagnósticos diferenciales en casos similares.…”