Pineal Region Tuberculoma Caused by Mycobacterium bovis as a Complication of Bacille Calmette-Guérin Vaccine: Case Report and Review of the Literature.

Abstract

Brain tuberculoma is a rare manifestation of tuberculosis especially in immunosuppressed patients. The definitive diagnosis may be difficult owing to mimicking brain tumors and the absence of the common presentation. Bacille Calmette-Guérin (BCG) vaccine is used for protection against tuberculous meningitis and miliary disease, more so in children, and also for the treatment of bladder cancer. The following case of brain tuberculoma is a boy aged 6 months who was presented to our hospital with poor feeding, nausea and vomiting, and confusion lasting 1 month. A brain magnetic resonance imaging scan showed a large mass lesion in the pineal region with generalized hydrocephaly in which polymerase chain reaction assays of the tissue was positive for Mycobacterium bovis and had a good response to antituberculosis drugs and surgery. We present a case of brain tuberculoma as the complication of BCG vaccine. To our knowledge, this case is the first case of brain tuberculoma after BCG vaccination. We should consider brain tuberculoma that presents with a similar presentation in any infants with a history of BCG vaccination.