Cerebral Tuberculoma Mimicking Brain Tumor

Introduction: Infection of the central nervous system (CNS) with Mycobacterium tuberculosis (MT) typically presents with meningitis of the basal cisterns and/or localized infections either with tuberculoma (tuberculous granuloma) or tuberculous abscess. In this context, the combination of meningitis and parenchymal lesions visualized in brain MRI is highly suspicious of tuberculosis, though diagnosis is often challenging especially in atypical presentation of the disease. CNS infection is considered to be a secondary disease after previous pulmonary tuberculosis and hematogenous spread of the infective agent. Diagnosis of cerebral tuberculosis is based on detection of MT DNA with polymerase chain reaction (PCR), growth of MT in a cerebrospinal fluid (CSF) culture or detection of acid-fast bacilli in the CSF. Secondary indicator of tuberculosis is a positive interferon-gamma release assay (IGRA) testing in a blood sample together with typical imaging features, though this testing cannot d ...