A rare case of central nervous system tuberculosis

Area of Science:

• Neurology
• Infectious Diseases
• Radiology

Background:

• Intracranial abscesses are rare, particularly those caused by tuberculosis (TB).
• Central nervous system (CNS) TB, especially in abscess form, is uncommon in non-HIV infected individuals.
• This case highlights a rare presentation of CNS TB in an elderly patient.

Purpose of the Study:

• To report a rare case of a central nervous system tuberculous abscess.
• To emphasize the diagnostic challenges in non-HIV infected patients.
• To discuss the clinical presentation and diagnostic confirmation of CNS TB abscess.

Main Methods:

• Case presentation of an 82-year-old male with altered mental status and renal failure.
• Diagnostic imaging including cross-sectional imaging and MRI.
• Brain biopsy and acid-fast bacilli (AFB) cultures for definitive diagnosis.

Main Results:

• Multiple ring-enhancing lesions were identified in the brain.
• Worsening of lesions, vasogenic edema, and mass effect were observed on follow-up MRI.
• Diagnosis of CNS TB abscess was confirmed by positive AFB cultures.

Conclusions:

• Central nervous system tuberculosis abscess is an exceedingly rare condition.
• Diagnostic confirmation can be challenging, requiring microbiological evidence.
• Early diagnosis and treatment are crucial, though outcomes can be poor in severe cases.