Spectrum of Atypical Presentation of Tubercular Infections of Central Nervous System—Case Series and Review of Literature


Tubercular infections of central nervous system commonly present with hydrocephalus, basal exudates, infarcts, tuberculomas, etc. However, rarely there are atypical lesions which can pose greater difficulty in differentiating from other lesions like tumors. This case series describes the spectrum of such lesions, with review few individual reports found in literature. Clinical presentations were weakness of limbs, slurring of speech and underlying primary tubercular focus. The age group ranged from 16 - 60 years with M:F ratio being 1:1. Spectrum of such lesions is discussed here with emphasis on the role of magnetic resonance imaging in prompt diagnosis. Thus initiating an early conservative line of management and its follow up with aversion of neurointervention which has its own inherent complications, the final outcome is a reduction in morbidity and mortality (as noted in the follow up) as well as patient cost care.

Share and Cite:

Sharma, P. (2015) Spectrum of Atypical Presentation of Tubercular Infections of Central Nervous System—Case Series and Review of Literature. Journal of Tuberculosis Research, 3, 90-96. doi: 10.4236/jtr.2015.33014.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Arseni, C. (1958) Two Hundred and One Cases of Intracranial Tuberculoma Treated Surgically. Journal of Neurology, Neurosurgery & Psychiatry, 21, 308-311. http://dx.doi.org/10.1136/jnnp.21.4.308
[2] Jinkins, J.R. (1988) Focal Tuberculous Cerebritis. American Journal of Neuroradiology, 9, 121-124.
[3] Honnorat, E., De Broucker, T., Mailles, A. and Stahl, J.P. (2013) Le Comité De Pilotage Et Groupe Des Investigateurs. Encephalitis Due to Mycobacterium tuberculosis in France. Médecine et Maladies Infectieuses, 43, 230-238. http://dx.doi.org/10.1016/j.medmal.2013.05.003
[4] Dastur, D.K. and Udani, P.M. (1966) The Pathology and Pathogenesis of Tuberculous Encephalopathy. Acta Neuropathologica, 6, 311-326. http://dx.doi.org/10.1007/BF00688161
[5] Glaser, C.A., et al. (2003) In Search of Encephalitis Etiologies: Diagnostic Challenges In the California Encephalitis Project, 1998-2000. Clinical Infectious Diseases, 36, 731-742.
[6] Abercrombie, J. (1828) Pathological and Practical Researches on Disease of the Brain and the Spinal Cord. Waugh and Innes, Edinburg, 371-372.
[7] Lu, M. (2010) Imaging Diagnosis of Spinal Intramedullary Tuberculoma: Case Reports and Literature Review. Journal of Spinal Cord Medicine, 33, 159-162.
[8] Nussbaum, E.S., Rockswold, G.L., Bergman, T.A., Erickson, D.L. and Seljeskog, E.L. (1995) Spinal Tuberculosis: A Diagnostic and Management Challenge. Journal of Neurosurgery, 83, 243-247.
[9] MacDonnell, A.H., Baird, R.W. and Bronze, M.S. (1990) Intramedullary Tuberculomas of the Spinal Cord: Case Report and Review. Reviews of Infectious Diseases, 12, 432-439.
[10] Lin, J., Feng, H., Ai, S. and Wang, X. (2006) Intramedullary Cervical Tuberculoma. Spinal Cord, 44, 809-812. http://dx.doi.org/10.1038/sj.sc.3101896
[11] Sharma, M.C., Arora, R., Deol, P.S., Mahapatra, A.K., Sinha, A.K. and Sarkar, C. (2002) Intramedullary Tuberculoma of the Spinal Cord: A Series of 10 Cases. Clinical Neurology and Neurosurgery, 104, 279-284. http://dx.doi.org/10.1016/S0303-8467(01)00196-2
[12] Blumberg, E.A. and Gil, R.A. (1990) Cerebellar Syndrome Caused by Isoniazid. DICP, 24, 829-831.
[13] Peter, P. and John, M. (2014) Isoniazid-Induced Cerebellitis: A Disguised Presentation. Singapore Medical Journal, 55, E17-E19.
[14] Sharma, P. Isoniazid Cerebellitis. http://www.ajnr.org/site/imgquiz/03092015qz.xhtml

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.