TUBERCULAR ABCESS MIMICKING A UNIQUE METASTATIC CEREBELLAR LESION

Claire Karekezi, HAJAR BECHRI, KOMI EGU, NIZARE EL FATEMI, RACHID EL MAAQILI, NAJIA EL ABBADI

Résumé


INTRODUCTION

CNS (Central nervous system) tuberculosis presents mainly as Tuberculoma or Meningitis. Tubercular brain abscess as an encapsulated collection of pus containing viable tubercle bacilli remains highly uncommon and only few cases have been reported in the literature.

CASE PRESENTATION

We report the case of a 36 year-old immune-compentent female who presented with complaints of sub-acute onset of occipitonuchal headache associated vomiting 3 months back. There was no history of fever, no records of tubercular contact. Physical examination revealed papillar edema on fundus with no motor deficit; no cerebellar signs were present. The Magnetic resonance imaging (MRI) showed an Intra axial T1 hypointense and T2 hyperintense parenchymal lesion in the right cerebellum with a gadolinium ring enhancement and hydrocephalus. An emergent CSF (cerebro-spinal fluid) shunting was performed followed by a surgical removal of lesion. Pathology report revealed a tubercular abscess. Anti-tubercular therapy was started and patient is under regular clinical follow up with good improvement.

CONCLUSION

Tubercular brain abscesses can mimic any other intracranial mass lesion in several cases. Thus, the diagnosis should be based on bacteriological and histological findings when history and physical examination is unremarkable

 

 


Mots-clés


Tubercular abscess, CNS tuberculosis, surgical removal, anti-tubercular therapy

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