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Miliary tuberculosis with left brachial monoplegia: A case report
Nayyar Iqbal1, Nagarajan Natarajan1, Sivakumar Periyasamy1
1Department of General Medicine, Pondicherry Institute of Medical sciences, Puducherry, India.
The Australasian Medical Journal
|November 8, 2014
Summary
Brain tuberculoma, a common intracranial mass in developing nations, can cause neurological symptoms. This case highlights the rare simultaneous occurrence of brain tuberculoma and miliary tuberculosis in an immunocompetent patient, with neurological deficits improving after treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Tuberculoma of the brain is a significant cause of intracranial masses in developing countries, often presenting with focal neurological deficits or seizures.
- The simultaneous occurrence of brain tuberculoma and miliary tuberculosis in the lungs is rare, particularly in immunocompetent individuals.
Observation:
- A case of an immunocompetent patient presenting with acute onset left brachial monoplegia, upper motor neuron facial palsy, and fever is described.
- Brain magnetic resonance imaging (MRI) revealed multiple granulomas, and chest X-ray showed miliary mottling, indicative of disseminated tuberculosis.
Findings:
- The patient exhibited monoplegia and miliary tuberculosis, a rare combination.
- Neurological deficits showed improvement following treatment with corticosteroids and anti-tubercular therapy.
Implications:
- This case underscores the importance of considering disseminated tuberculosis in the differential diagnosis of intracranial masses, even in immunocompetent patients.
- Early diagnosis and combined treatment of neurological and pulmonary tuberculosis can lead to favorable outcomes and resolution of neurological deficits.
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