Cerebral Tuberculoma without Clinical Pulmonary Tuberculosis Mimicry as Cerebral Abscess: (A Rare Case Report) | Biomedgrid

Cerebral tuberculoma is approximately 10-15% of intracranial tuberculosis cases and 1% of all Mycobacterium tuberculosis (MTB) cases. Mostly, Cerebral tuberculoma is always accompanied by pulmonary tuberculosis infection. However, clinical and radiological symptoms of cerebral tuberculoma has mimicry with other brain infections. Gold standard of cerebral tuberculoma is histopathological finding, but it isn't hard to do so MRI and MRI spectroscopy are used to make sure this diagnosis. In this case we will explore cerebral tuberculoma without clinical pulmonary tuberculosis has mimicry cerebral abses Case Presentation: 20-years-old woman, complained a progressive left side body weakness accompanied by an intermittent headache for 6 months ago. She had also complained a discharge appeared from both ears for 7 months ago. Patient's contact history of tuberculosis was doubtful. Hemiparese dextra and smelly yellowish discharge from both ears was found from the examination. Neurological examination: there is no meningeal sign, patient has left hemiparese, the discharge and sputum Gene expert test did not show any sign of MTB. Weber test showed no lateralization and Rinne was negative. Based on contrast head MRI, Multiple lesions in cerebellum, right parietal lobe, and left occipital lobe accompanied by cerebral edema was found, suggestive of cerebral abscess. However, subsequent examination using MR spectroscopy suggested a brain tuberculoma. Oral Anti tuberculosis therapy had shown satisfying result. Conclusion: There are similarities in clinical symptoms and radiological findings between cerebral tuberculoma and cerebral abscess, it is necessary to have MR spectroscopy as a substitution if there are no histopathological examination available.