Posterior fossal tuberculoma: an unusual presentation of extrapulmonary tuberculosis
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Keywords
mycobacterium tuberculosis, tuberculoma
Abstract
A tuberculoma is a conglomerate of foci of caseous necrosis in the brain parenchyma produced by hematogenous dissemination. Tuberculosis of the central nervous system has an incidence of 0.06 per million inhabitants, corresponding to 1% of all cases of tuberculosis and 6-10% of extrapulmonary forms in immunocompetent patients. We present the case of a 57-year-old patient with headache of 48 hours of evolution, holocranial, prosopagnosia and psychomotor agitation with tendency to violence. At the same time, he reported unquantified fever, predominantly at night, with the same evolution. CBC with normal findings, serology: HBV, HCV, HIV negative. Chest X-ray showed pleural thickening. CT and MRI showed lesion with ring enhancement pattern in cerebellum. Lumbar puncture was performed reporting: protein: 456mg/dL, glucose: 10mg/dL, cells: 105mm3, mononuclear: 100%, ADA: 23.84U/L, GeneXpert: positive. Antipyretic treatment and steroids were given. Patient evolved satisfactorily.
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Byron Josué Degrandes Rodríguez, Instituto Nacional Cardiopulmonar. Tegucigalpa, Honduras
Médico Especialista en Medicina Interna