Alcohol induced psychosis with Confabulation and Tuberculoma

Abstract Introduction-An association between alcohol and pulmonary tuberculosis has been established by many studies. Alcohol causes reactivation of pulmonary tuberculosis and its extra pulmonary presentation may present with non specific neurological signs and cause cognitive and behavioural changes which are more likely to be confounded by the social and other factors. Case report -Mr. X, 55 yr-old-male was admitted with irrelevant talk, sleep disturbance, aggressive behaviour, memory disturbance and hearing voices. Clinical examination revealed the diagnosis of Alcohol induced behavioural disorder. There was past ho treatment for pulmonary tuberculosis 15 years back and past ho of 5 episodes of seizure on period of abstinent. With the focal neurological signs of hemianopia, he was subjected to MMSE and the score was 20 out of 30. Imaging studies revealed multiple ring enhancing lesions over right parieto occipital region. Physician and Neurologist concurred the diagnosis of tuberculoma- brain .He was started on ATT and follow up examination showed improvement in clinical status. Discussion and ConclusionIn- case of alcoholic withdrawal seizure we should think of organic focus. In addition to Clinical examination screening instrument like MMSE may be useful tool. An alcohol associated with constitutional symptoms like fever, loss of weight along with previous history of pulmonary tuberculosis should screen for reactivation of tuberculosis. So this highlights the need and importance of the liaison psychiatry in general hospital milieu.