Clinical and radiographic findings in disseminated tuberculosis of the brain.

Abstract

We report clinical and radiographic findings in a patient with disseminated tuberculosis (TB) of the brain. A Burmese man developed a left hemiparesis and mild cognitive difficulty 1 month into therapy for miliary TB. A head MRI showed numerous (> 100) contrast-enhancing supratentorial and infratentorial lesions. Following 9 months of treatment with isoniazid, ethambutol, rifampin, and pyrazinamide, most lesions resolved; however, one cortical tuberculoma enlarged significantly. The patient was continued on isoniazid and rifampin, with radiographic resolution of the tuberculoma 4 months later.