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Archivos de Medicina Interna

Print version ISSN 0250-3816On-line version ISSN 1688-423X

Abstract

ROMERO, Selva; LLAMBI, Laura; FERNANDEZ, Isabel  and  ALVAREZ ROCHA, . Alfredo. Brain Tuberculoma in an Immunocompetent Patient. Arch. Med Int [online]. 2011, vol.33, n.2, pp.45-48. ISSN 0250-3816.

Uruguay presents a low prevalence of tuberculosis. The brain tuberculoma represents 1% of the total number of cases of tuberculosis in immunocompetent. Clinical case: female, 45 years old, diabetes type 2, progressive paresis and right brachial hypoesthesia with partial seizures. Image studies showed left fronto-parietal lesions, human immunodeficiency virus (HIV) serology: negative, ESR: 24 mm/h; PPD: 3 mm. Stereotactic biopsy was performed. Histopathological findings: granulomas with caseous necrosis. Culture: Mycobacterium tuberculosis. Medical treatment with antituberculous drugs was indicated according to national guidelines, with clinical and imagenologic remission. The delay in the diagnosis in immunocompetent is approximately four times higher than in immunosuppressed. The clinical presentation is imprecise; headache, seizures and hemiparesis are frequent. MRI has diagnostic sensitivity, however no pathognomonic images of tuberculoma are described. Treatment is based in antituberculous drugs, neurosurgery is reserved for cases with endocranial hypertension and progression under medical treatment. The response to treatment is monitored with the remission of symptoms and control imaging, however remission in MRI is slow

Keywords : tuberculoma; cerebral tuberculosis; intracranial tumor.

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