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Case Reports
. 2017 Apr 4;4(3):329-333.
doi: 10.1002/ams2.272. eCollection 2017 Jul.

A case of cerebral tuberculoma mimicking neurocysticercosis

Hiroko Yuzawa  1 , Yousuke Hirose  1 , Tomonori Kimura  1 , Sho Kimura  1 , Hisanori Sugawara  1 , Asako Yanagisawa  1 , Sono Toi  2 , Takashi Ohashi  2 , Tomohito Sadahiro  1
Affiliations
Case Reports

A case of cerebral tuberculoma mimicking neurocysticercosis

Hiroko Yuzawa et al. Acute Med Surg. .

Abstract

Case: A 42-year-old Peruvian woman residing in Japan for 11 years with a family history of neurocysticercosis presented to our intensive care unit with fever and intense headache.Computed tomography indicated multiple micronodular lesions in the brain parenchyma, and cerebral tuberculoma and neurocysticercosis were considered in the differential diagnosis. Neurocysticercosis was initially suspected, and oral praziquantel was initiated. However, because of a high adenosine deaminase level in the cerebrospinal fluid and positive peripheral blood interferon gamma release test result, cerebral tuberculoma was subsequently considered.

Outcome: Antituberculous drugs with steroids were initiated on day 10, after which the symptoms gradually resolved; the patient was discharged on day 29. Gadolinium-contrast magnetic resonance imaging 8 months later showed reduced nodular shadows, confirming cerebral tuberculoma.

Conclusion: Immediate diagnosis and treatment are imperative for cerebral tuberculoma, a lethal infection. Considering the recent increases in immigration worldwide, increased cases of tuberculoma mimicking neurocysticercosis are expected.

Keywords: Adenosine deaminase; immigrants; interferon gamma release tests; intracranial tuberculoma; neurocysticercosis.

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Figures

Figure 1
Figure 1
Head computed tomography images on intensive care unit admission of a 42‐year‐old Peruvian woman with fever and severe headaches, showing multiple micronodular lesions in the brain parenchyma.
Figure 2
Figure 2
Head magnetic resonance images on intensive care unit admission of a 42‐year‐old Peruvian woman with fever and severe headaches. Upper panels, T1‐weighted images showing an isointense nodular lesion and a hypointense nodular lesion. Middle panels, T2‐weighted images showing the isointense nodular lesion on T1‐weighted image becoming hyperintense, while the hypointense nodular lesion became hypointense with a hyperintense fringe. Lower panels, Gadolinium‐contrasted T1‐weighted images showing ring‐enhancing lesions.
Figure 3
Figure 3
Clinical course of a 42‐year‐old Peruvian woman with cerebral tuberculoma after intensive care unit admission.
See this image and copyright information in PMC

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