TY - JOUR
T1 - Atypical cerebral manifestations of disseminated Mycobacterium tuberculosis
AU - Hwang, Ji Hye
AU - Lee, Kyung Mi
AU - Park, Ji Eun
AU - Kim, Hyug Gi
AU - Kim, Eui Jong
AU - Choi, Woo Suk
AU - Yang, Na Rae
N1 - Funding Information:
This work was supported by Basic Science Research Program through the Ministry of Education of the Republic of Korea (NRF-2016R1D1A1B03933173) and the National Research Foundation of Korea (NRF), grant funded by the Korea Government (MSIP) (NRF-2017R1E1A2A02067113).
Publisher Copyright:
© 2017 Hwang, Lee, Park, Kim, Kim, Choi and Yang.
PY - 2017/9/21
Y1 - 2017/9/21
N2 - Background: We investigated the patterns of cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis or disseminated tuberculosis. Materials and methods: From January 2010 to September 2016, brain magnetic resonance imaging (MRI) scans were obtained to evaluate cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis. We also included patients with drug-resistant tuberculosis or disseminated tuberculosis. MRI findings of tuberculous meningitis and tuberculoma were classified as typical; other MRI findings were classified as atypical. Demographic data, risk factors, and drug regimens were collected and analyzed. Results: Twenty-two patients were diagnosed with cerebral tuberculosis. Cerebral tuberculosis was due to hematogenous spread from pulmonary tuberculosis (10 patients), spinal tuberculosis (8 patients), disseminated tuberculosis (3 patients), and unknown causes (1 patient). There were six patients with typical MRI findings (three patients with typical meningitis involving the basal cistern and supratentorium, one patient with tuberculomas, and two patients with both) and seven patients with atypical MRI findings [five patients with evidence of early meningitis, such as high signal intensity on fluid-attenuated inversion recovery (FLAIR) along the cerebellar folia, and two patients with only hydrocephalus]. Conclusion: Besides the typical sites of meningeal involvement, overlooked findings such as FLAIR abnormalities along the cerebellar folia or hydrocephalus should be checked for early detection of cerebral tuberculosis and initiation of the appropriate treatment against disseminated tuberculosis.
AB - Background: We investigated the patterns of cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis or disseminated tuberculosis. Materials and methods: From January 2010 to September 2016, brain magnetic resonance imaging (MRI) scans were obtained to evaluate cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis. We also included patients with drug-resistant tuberculosis or disseminated tuberculosis. MRI findings of tuberculous meningitis and tuberculoma were classified as typical; other MRI findings were classified as atypical. Demographic data, risk factors, and drug regimens were collected and analyzed. Results: Twenty-two patients were diagnosed with cerebral tuberculosis. Cerebral tuberculosis was due to hematogenous spread from pulmonary tuberculosis (10 patients), spinal tuberculosis (8 patients), disseminated tuberculosis (3 patients), and unknown causes (1 patient). There were six patients with typical MRI findings (three patients with typical meningitis involving the basal cistern and supratentorium, one patient with tuberculomas, and two patients with both) and seven patients with atypical MRI findings [five patients with evidence of early meningitis, such as high signal intensity on fluid-attenuated inversion recovery (FLAIR) along the cerebellar folia, and two patients with only hydrocephalus]. Conclusion: Besides the typical sites of meningeal involvement, overlooked findings such as FLAIR abnormalities along the cerebellar folia or hydrocephalus should be checked for early detection of cerebral tuberculosis and initiation of the appropriate treatment against disseminated tuberculosis.
KW - Atypical tuberculosis meningitis
KW - Disseminated tuberculosis
KW - Post-contrast fluid-attenuated inversion recovery
KW - Tuberculoma
KW - Tuberculous meningitis
UR - http://www.scopus.com/inward/record.url?scp=85029612842&partnerID=8YFLogxK
U2 - 10.3389/fneur.2017.00462
DO - 10.3389/fneur.2017.00462
M3 - Article
AN - SCOPUS:85029612842
SN - 1664-2295
VL - 8
JO - Frontiers in Neurology
JF - Frontiers in Neurology
IS - SEP
M1 - 462
ER -