Intracerebral Tuberuloma Misdiagnosed
We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test.
Tuberculosis incidence has increased significantly worldwide and controlling multidrug resistant Mycobacterium tuberculosis is a global public health priority. Hematogenous spread to the meninges and other organs occurs early in the course of infection. Fifteen to 20% of extrapulmonary tuberculosis (TB) cases involve the central nervous system (CNS), manifesting as meningitis, cerebritis, tuberculomas, or tubercular abscesses. Intracranial tuberculomas are rare, accounting for 0.2% of intracranial space-occupying lesions. The radiologic findings are often nonspecific, and they are difficult to diagnose without an increased index of suspicion. We describe two cases of intracerebral tuberculomas in patients testing negative for human immunodeficiency virus (HIV) who were misdiagnosed as having neurosarcoidosis.
We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test.
Tuberculosis incidence has increased significantly worldwide and controlling multidrug resistant Mycobacterium tuberculosis is a global public health priority. Hematogenous spread to the meninges and other organs occurs early in the course of infection. Fifteen to 20% of extrapulmonary tuberculosis (TB) cases involve the central nervous system (CNS), manifesting as meningitis, cerebritis, tuberculomas, or tubercular abscesses. Intracranial tuberculomas are rare, accounting for 0.2% of intracranial space-occupying lesions. The radiologic findings are often nonspecific, and they are difficult to diagnose without an increased index of suspicion. We describe two cases of intracerebral tuberculomas in patients testing negative for human immunodeficiency virus (HIV) who were misdiagnosed as having neurosarcoidosis.