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Case Reports
. 2020 Mar 12;12(3):e7248.
doi: 10.7759/cureus.7248.

Multiple Intracranial Tuberculomas with an Intra-medullary Spinal Cord Tuberculoma in a Pediatric Patient

Sreenath Meegada  1 , Richmond Gyamfi  2 , Vijayadershan Muppidi  3 , Vasuki Dandu  4 , Tejo Challa  1
Affiliations
Case Reports

Multiple Intracranial Tuberculomas with an Intra-medullary Spinal Cord Tuberculoma in a Pediatric Patient

Sreenath Meegada et al. Cureus. .

Abstract

Central nervous system (CNS) tuberculosis (TB), caused by Mycobacterium tuberculosis (MT), is a severe form of TB, which presents as meningitis, cerebritis, abscesses, spinal tuberculous arachnoiditis, and rarely tuberculomas. CNS TB is prevalent in the underdeveloped or developing world and is common in malnourished, alcoholics, children, young adults, immunocompromised, and cancer patients. Intracranial tuberculomas (ICT) can present with symptoms and signs of focal neurological deficits with or without systemic manifestations. ICT is the least common presentation of CNS TB. Medical management with anti-TB drugs and steroids is the mainstay of treatment, while surgical intervention is usually reserved for refractory cases. Here, we present the case of a 10-year-old Indian American girl with headaches, diplopia, fever, and neck pain diagnosed with ICT and intramedullary spinal cord tuberculoma.

Keywords: central nervous system tuberculosis; cerebral tuberculomas; disseminated tuberculosis; intra-medullary spinal cord tuberculoma; intracranial tuberculoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Magnetic resonance imaging (MRI) of the brain with gadolinium contrast showing multiple ring enhancing lesions
Figure 2
Figure 2. Magnetic resonance imaging (MRI) of the spine with gadolinium contrast showing 9-mm ring enhancing lesion (red arrow)
Figure 3
Figure 3. Biopsy tissue revealed acid-fast stain positive for bacilli (red arrow)
Figure 4
Figure 4. Caseating granulomas seen on hematoxylin and eosin stain (green arrows)
Figure 5
Figure 5. Pre- (left) and post-treatment (right) magnetic resonance imaging (MRI) scans of the brain showing decreasing lesions (red arrows)
Figure 6
Figure 6. Pre- (left) and post-treatment (right) magnetic resonance imaging (MRI) scans of the spine showing decreasing size of spine lesion (red arrows)
See this image and copyright information in PMC

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