Tuberculomas of the Brain

Asenjo, A; Valladares, H; Fierro, Juan L.

doi:10.1001/archneurpsyc.1951.02320020018002

Cited by 62 publications

(12 citation statements)

References 4 publications

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“…This is of some importance at operation, for if this fact is not appreciated the specimen may be fixed in formalin and the opportunity of obtaining material for culture and sensitivity studies is lost. The incidence of multiple tuberculomas is variable; they are not mentioned by Dastur and Desai in their series of 114 verified tuberculomas but Castro and Lepe (1963) quote an incidence of 16% and Asenjo et al (1951) found 32% of multiple tuberculomas in their material.…”

mentioning

confidence: 92%

Three patients with intracranial tuberculomas with unusual features

Thrush

Barwick

1974

Journal of Neurology, Neurosurgery & Psychiatry

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confidence: 92%

Three patients with intracranial tuberculomas with unusual features

Thrush

Barwick

1974

Journal of Neurology, Neurosurgery & Psychiatry

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“…Results vary from 25% to 75% (19,29) and may be negative in these patients (12). The role of tuberculin skin testing in liver transplant patients is unclear because half the patients in a series with proven tuberculosis in OLT were PPD-negative before transplantation (1).…”

mentioning

confidence: 99%

Intracranial Tuberculoma in a Liver Transplant Patient: First Reported Case and Review of the Literature

Henderson

Meyers

Gultekin³

et al. 2003

American Journal of Transplantation

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A 66-year-old female who had undergone an orthotopic liver transplant two years before admission was admitted with fever and neurological symptoms of several days' duration. Following an extensive work-up, which revealed positive intracranial lesions on computed typography and magnetic resonance imaging, the patient was begun on broad spectrum antimicrobials including corticosteroids. The patient responded though the etiology of infection remained unclear. After a stereotactic biopsy was performed revealing granulomas and acid-fast bacilli, the patient was started on antituberculous medications. A review of the literature reveals that the rare occurrence of intracranial tuberculoma should be considered in an orthotopic liver transplant (OLT) patient with central nervous system pathology. Case ReportThe incidence and factors associated with tuberculosis in liver transplant patients are not clear (1,2). Tuberculosis involving the central nervous system occurs in only 0.53% of cases of systemic tuberculosis in this country (3). Though intracranial tuberculoma is a common entity in developing countries, cases of tuberculosis involving the central nervous system (either tuberculomas or meningitis) have rarely been reported (4,5). Intracranial tuberculoma in the liver transplant patient has not been previously described. We report a case of a patient who developed neurological symptoms, likely related to intracranial tuberculoma, and died from cerebral hemorrhage. 88An indigenous 66-year-old hispanic female with a history of noninsulin dependent diabetes mellitus, who had a cadaveric liver transplantation for cirrhosis two years earlier, was admitted for confusion, headache, fever, vomiting and diarrhea. The patient was recently discharged after being hospitalized for fever, headache, and confusion without a diagnosis. There was no previous history of tuberculosis in the patient or her family; her purified protein derivative (PPD) status before admission and transplantation was unknown.The patient was in good health several days earlier and was taking prednisone 10 mg qd, cyclosporine 25 mg bid, nystatin, cardiazem and neurontin. The patient denied recent travel, any contact with illness and had no pets.On examination, the patient was febrile, 40.1 aeC, pulse 110 beats/min, blood pressure 133/71 mmHg, respiratory rate 20 breaths/min, and was saturating 98% on room air. She was alert, yet disoriented. No meningismus or adenopathy was noted. Examination of the heart, lungs, and the abdomen was normal. Cranial nerves were intact, and muscle strength was within normal limits, including deep tendon reflexes.Laboratory analysis revealed: hemoglobin, 11.0 g/dL; hematocrit, 31.6%; platelets, 345 ¿ 10 9 /L; white blood cells (WBC), 11.8 ¿ 10 9 /L, with 83.7% neutrophils; sodium, 136 mmol/L; potassium, 3.8 mmol/L; chloride, 101 mmol/L; carbon dioxide, 19; BUN, 60 mmol/L; creatinine, 2.5 mg/dL; glucose, 128 mg/dL; total bilirubin 0.7 mg/dL, direct bilirubin 0.3 mg/ dL, AST Ω 41 U/L, ALT Ω 15 U/L, AP Ω 194 U/L; a PPD was not per...

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“…As demonstrated above, the CAT scanner only reveals a nonspecific intracranial mass (Leibrock et al 1976). Multiple lesions may be present in as many as 32% of cases (Asenjo et al 1951, Capon et al 1975, Castro et al 1963, Thrush et al 1974.…”

Section: Discussionmentioning

confidence: 99%

Intracranial tuberculomas and the CAT scan

1978

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Tuberculomas of the brain are rare in the United States. Although CAT (computerized axial tomography) scanning cannot distinguish these infections from other intracranial mass lesions, it provides a non-invasive technique with which to follow the course of presumptive lesions during medical therapy, and with which to search for clinically unsuspected infections. The necessity for and timing of surgery can be considered more easily with this technique. Two cases are presented with their CAT scans, including one example of the disappearance of a presumptive tuberculoma, during appropriate medical therapy.

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Tuberculomas of the Brain

Cited by 62 publications

References 4 publications

Three patients with intracranial tuberculomas with unusual features

Three patients with intracranial tuberculomas with unusual features

Intracranial Tuberculoma in a Liver Transplant Patient: First Reported Case and Review of the Literature

Intracranial tuberculomas and the CAT scan

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