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Tuberculosis

TB in the Fossa Region

06/08/2009

Question:

MRI of my father-in-law (72) shows an anomaly in fossa region, suspected to be either a tumour or TB infection. Symptoms are ataxia and occassional headache for past two months. The former is most prominent. Is it possible to have TB infection in this area?

Answer:

Yes, it is possible to have a tuberculosis (TB) lesion (tuberculoma) in the brain. In fact, in developing countries where TB is endemic, tuberculomas are the most common cause of brain lesions. It is rare in developed countries. Depending on where in the brain the tuberculoma is, it can cause symptoms of ataxia and headache. An MRI may be suggestive of TB but cannot differentiate it from other tumors. So, if your father in-law has a known history of TB exposure, infection, or disease, the chance of the brain lesion being due to TB is higher.

The gold standard for diagnosis and confirmation that it is TB is based on biopsy but this may be difficult to obtain. Often, patients are started on treatment for TB, and recover with medical treatment. Close follow-up with a TB specialist and neurologist is needed.

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Response by:

Shu-Hua   Wang, MD, MPH&TM Shu-Hua Wang, MD, MPH&TM
Clinical Assistant Professor of Infectious Diseases
Clinical Assistant Professor of The Division of Epidemiology
College of Medicine
The Ohio State University

Larry S Schlesinger, MD Larry S Schlesinger, MD
Professor:
Molecular Virology, Immunology and Medical Genetics
Microbiology Administration
Environmental Health Sciences
College of Medicine
The Ohio State University