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Tuberculous brain abscess. Case report

P R González, C V Herrero, G F Joachim

Journal of Neurosurgery

|March 1, 1980

Summary

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A rare tuberculous abscess in the occipital region was surgically removed from an elderly woman. Despite treatment, she succumbed to pneumonia, with autopsy revealing disseminated tuberculosis, highlighting the challenges of this uncommon presentation.

Area of Science:

Neurology
Infectious Diseases
Pathology

Background:

Tuberculosis (TB) can present with rare extrapulmonary manifestations.
Tuberculous abscesses are infrequently reported, particularly in the central nervous system.

Observation:

A 73-year-old woman presented with an occipital abscess without prior history of TB.
The patient subsequently developed aspiration bronchopneumonia and expired.
Autopsy confirmed basilar tuberculous meningitis and miliary tuberculosis in multiple organs.

Findings:

The case represents the 18th reported instance of a tuberculous abscess.
No evidence of chronic tuberculous infection was found in any organ.
Disseminated miliary tuberculosis was present despite the localized initial abscess.

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Implications:

This case underscores the potential for tuberculosis to manifest as localized abscesses, even without a known history of the disease.
The findings emphasize the importance of considering tuberculosis in the differential diagnosis of unexplained abscesses.
Disseminated miliary tuberculosis can occur rapidly, posing a significant diagnostic and therapeutic challenge.