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Updated: May 26, 2026
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In Vivo Imaging Systems (IVIS) Detection of a Neuro-Invasive Encephalitic Virus
Published on: December 2, 2012
Images in Neurology: Cortical Encephalitis in CNS Tuberculosis
Pranay Gupta1, Saman Fatima1, Pranav Gupta2
1Department of Neurology, GIPMER, Delhi, India.
The Neurohospitalist
|May 25, 2026
Summary
This case highlights a rare presentation of central nervous system tuberculosis (CNS TB) involving cerebral parenchymal involvement. Early diagnosis and treatment of CNS TB with Anti-Tubercular Therapy (ATT) and Multi-Drug Therapy (MDT) are crucial.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Leprosy patients with defaulted treatment are at risk for opportunistic infections.
- Central nervous system (CNS) involvement in tuberculosis is uncommon, with parenchymal involvement being extremely rare.
Purpose of the Study:
- To report an extremely rare case of CNS tuberculosis presenting as cortical encephalitis/cerebritis.
- To emphasize the importance of considering CNS TB in patients with neurological deficits and a history of leprosy.
Main Methods:
- Case report of a 53-year-old male with a history of leprosy.
- Diagnostic workup included cerebrospinal fluid (CSF) analysis, Magnetic Resonance Imaging (MRI), and lymph node biopsy.
- Treatment involved Anti-Tubercular Therapy (ATT), Multi-Drug Therapy (MDT) for leprosy, steroids, and anti-seizure medications (ASM).
Main Results:
- The patient presented with fever, cognitive impairment, and focal seizures with hemiparesis.
- MRI revealed cerebral cortical lesions and a paraspinal abscess.
- Mycobacterium Tuberculosis was detected via CBNAAT from the paraspinal fluid, and lymph node biopsy showed caseous necrosis.
- The patient showed significant clinical and radiological improvement with treatment.
Conclusions:
- Cortical encephalitis/cerebritis is an exceedingly rare manifestation of CNS tuberculosis.
- Prompt diagnosis and combined treatment for CNS TB and leprosy are vital for patient outcomes.
- Despite initial improvement, the patient succumbed to sepsis complications from secondary pneumonia.
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