Multiple central nervous system tuberculomas in a pediatric patient: Case report

Chávez-Nomberto R.E.; Carranza S.; Uriarte S.; Ramos-Díaz K.J.; Espíritu-Rojas E.R. · Revista del Cuerpo Medico Hospital Nacional Almanzor Aguinaga Asenjo (2023) · DOI: 10.35434/rcmhnaaa.2023.163.1832

Resumen

Introduction: The finding of multiple tuberculomas in the central nervous system (CNS) in pediatric patients is rare. Case of report: We present the case of a pediatric patient admitted with a 6-month history of behavioral change, weight loss, headache, and left hemiparesis. Imaging studies showed multiple CNS tuberculomas, pulmonary milia, and hepatic granulomas. The cerebrospinal fluid study showed elevated protein. BK studies and the tuberculin skin test were negative. The interferon gamma test (IGRA) was positive. The patient received treatment with the anti-TB regimen I, with a good response. Follow-up brain MRIs showed a decrease in the number and size of the lesions. Conclusions: The presentation of multiple CNS tuberculomas is uncommon, with a broad differential diagnosis and a varied clinical presentation. In endemic countries such as Peru, it should be considered in the differential diagnosis.