Saleh Mwajabu A, Tu Long, Mango Mechris, Jacob Mboka, Minja Frank
Department of Radiology & Imaging, Muhimbili University of Health and Allied Sciences, UN Road, Upanga, Ilala, Dar es Salaam, Tanzania.
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
Radiol Case Rep. 2021 Dec 18;17(3):581-586. doi: 10.1016/j.radcr.2021.11.074. eCollection 2022 Mar.
Tuberculomas in the form of multiple ring-enhancing brain lesions is an uncommon occurrence in immunocompetent patient. Central nervous system tuberculosis may manifest as meningitis, tuberculoma, or abscess and can even occur in patients with or without active respiratory tract infection. In the case of active infection, specific antibiotic combinations and dosing duration are required, and respiratory isolation/precautionary measures must be taken by the health care workers and members of the family. Most literature has reported Central nervous system tuberculosis in patients with immunosuppression such as from HIV infection or solid organ transplantation; however, in endemic areas, CNS tuberculoma should be a differential consideration even for immunocompetent patients presenting with ring enhancing lesion (s). Our case highlights the importance of maintaining this clinical suspicion. Early diagnosis and management of our patient helped prevent potentially serious neurological sequelae.
在免疫功能正常的患者中,表现为多发环形强化脑病变的结核瘤并不常见。中枢神经系统结核可能表现为脑膜炎、结核瘤或脓肿,甚至可发生于有或无活动性呼吸道感染的患者。对于活动性感染,需要使用特定的抗生素组合并确定给药持续时间,医护人员和家庭成员必须采取呼吸道隔离/预防措施。大多数文献报道的中枢神经系统结核患者存在免疫抑制,如感染HIV或接受实体器官移植;然而,在流行地区,即使是出现环形强化病变的免疫功能正常患者,也应将中枢神经系统结核瘤作为鉴别诊断的考虑因素。我们的病例突出了保持这种临床怀疑的重要性。对我们患者的早期诊断和治疗有助于预防潜在的严重神经后遗症。