Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient

• Autor(a) principal: Pellegrino, Daniela
• Data de Publicação: 2010
• Outros Autores: Gerhardt, Juliana, Porfírio, Fátima M.V., Santos, Edgar de Bortholi, Dauar, Rafi F., Oliveira, Augusto C. Penalva de, Vidal, José E.
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
• Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/31354
• topic: Cerebral tuberculoma; Tuberculosis; Central nervous system; HIV

Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion) who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis was reached. However, a trial with first-line antituberculous drugs led to a significant clinical and radiological improvement. Atypical presentations of cerebral tuberculomas should always be considered in the differential diagnosis of intracranial mass lesions in HIV-infected patients and a trial with antituberculous drugs is a valuable strategy to infer the diagnosis in a subset of patients.