Tuberculous cerebritis and tuberculoma in a patient with AIDS: Literature review and case report

Tuberculous brain cerebritis, abscess and tuberculoma in AIDS patients are considered as rare conditions and only few cases have been reported in the literature. The present case is a 28-year-old man with AIDS and previous systemic tuberculosis,denied by him and his family. He was admitted to our department due to headache, hemiparesis and seizures. A brain computed tomography (CT) scan disclosed a frontal hypodense lesion with a non-homogenous contrast enhancement that was reported as a high grade glioma. Magnetic resonance imaging (MRI) showed a diffuse hypointenselesion in right frontal area on T1-weighted, and hyperintense on T2-weighted and flair view, but there was a small paraventricular region with hypointensity on both T1, T2 and flair series, which was also reported to be a high grade glioma. Because of clinical course and imaging findings, the patient was a candidate for operation. After operation, the results of pathology and laboratory examination confirmed the diagnosis of tuberculous brain cerebritis and tuberculoma with positive Acquired Immune Virus (HIV) serology. Thus, tuberculous cerebritis, tuberculoma and abscesses should be considered in the differential diagnosis of focal brain lesions in AIDS patients, but AIDS should also be consideredin every patient with an uncommon cerebral lesion who is not cooperative with medical healthcare providers. Surgical excision or biopsy and anti-tuberculous treatment are the mainstay in management of these lesions in patients with AIDS.