ISSN 2373-3586


Welcome to the Medical Science Case Reports

Medical Science Case Reports (MSCR) developed as an independent title journal in 2014 from the case reports section of Medical Science Monitor.

Aim of the Journal
MSCR is an Open Access, peer-reviewed online journal, which aims at contributions advancing health professional education and coverage of original case reports from all medical specialties. MSCR will expand medical knowledge and thus... read more

Published: 2016-09-21

Symptomatic Central Nervous System Tuberculomas After Completition of Tuberculosis Treatment in an Immunocompetent Adult: A Case Report

Dan Iulian Cuciureanu, Cristina Bîrzu, Cornelia Tudorache, Florentina Danciu, Irina Moisei Constantinescu

(Department of Neurology, Emergency Hospital “N. Oblu”, Iasi, Romania)

Med Sci Case Rep 2016; 3:72-76

DOI: 10.12659/MSCR.900276

BACKGROUND: Granulomatous basal meningitis is an uncommon manifestation of intracranial tuberculosis. Paradoxical reactions consisting of manifestation of or worsening of brain tuberculomas may arise during the proper treatment of tuberculosis. There are a few described cases of cerebral tuberculosis recrudescence after adequate completion of treatment and favorable outcomes.
CASE REPORT: We report the case of a 25 year-old male, immunocompetent, previously diagnosed with pulmonary tuberculosis and tuberculous meningitis and who underwent anti-tuberculous treatment for one year. The brain imagery performed at the time of the initial diagnosis revealed no intracerebral tuberculous lesions. Six months after the tuberculostatic treatment was stopped, the patient presented with a first epileptic seizure. A neurologic examination showed anisocoria. The cerebral CT scan with contrast enhancement revealed tuberculous meningitis and brain tuberculomas. The tuberculostatic therapy was reinitiated conjointly with antiepileptic treatment, with favorable clinical outcomes at one year follow-up interval. The imagery findings at one year showed persistent, but reduced tuberculosis lesions.
CONCLUSIONS: Development of tuberculous meningitis as a paradoxical reaction following appropriate anti-tuberculous therapy in an immunocompetent adult, and is rare and may represent a clinical and radiological challenge. Seizures are commonly associated with brain granulomas and most often resolve after successful medical treatment of the underlying CNS tuberculosis. However, these patients should be kept under observation even after completion of anti-tuberculous treatment. The... read more

Keywords: Epilepsy, Tuberculoma, Intracranial, Tuberculosis

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