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Revista do Instituto de Medicina Tropical de São Paulo
On-line version ISSN 1678-9946
PELLEGRINO, Daniela et al. Ring enhancing intracranial lesion responding to antituberculous treatment in an HIV-infected patient. Rev. Inst. Med. trop. S. Paulo [online]. 2010, vol.52, n.5, pp.285-287. ISSN 1678-9946. http://dx.doi.org/10.1590/S0036-46652010000500013.
Cerebral tuberculomas constitute a major differential diagnosis of cerebral toxoplasmosis in human immunodeficiency virus (HIV)-infected patients in developing countries. We report the case of a 34-year old woman co-infected with HIV and possible disseminated tuberculosis (hepatitis, lymphadenopathy, and pleural effusion) who presented a large and solitary intracranial mass lesion. Despite extensive diagnostic efforts, including brain, ganglionar, and liver biopsies, no definitive diagnosis was reached. However, a trial with first-line antituberculous drugs led to a significant clinical and radiological improvement. Atypical presentations of cerebral tuberculomas should always be considered in the differential diagnosis of intracranial mass lesions in HIV-infected patients and a trial with antituberculous drugs is a valuable strategy to infer the diagnosis in a subset of patients.
Keywords : Cerebral tuberculoma; Tuberculosis; Central nervous system; HIV.