Hyperthermia occurring with paradoxical development of cerebral tuberculomas

A 59-year-old male Moroccan who had been mechanically ventilated for extensive pulmonary tuberculosis, suddenly developed a generalized seizure with hyperthermia. He had been receiving adequate antituberculosis treatment for 2 weeks. Brain CT scan demonstrated the development of multiple cerebral tuberculomas. The brain CT scan that had been performed at the initiation of antituberculosis therapy was normal. Corticosteroids resulted in rapid improvement of the patient's clinical condition. The pathogenic mechanisms of the development of such lesions as well as their therapy and CT appearance are discussed.