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Yanto Budiman
Fakultas Kedokteran Universitas Atma Jaya, Jakarta. Department Radiologi Rumah Sakit Atma Jaya, Jakarta

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ABSES TUBERKULOSA OTAK PADA REMAJA DENGAN HIV NEGATIF Mayo Djitro; Yanto Budiman; Ronny Ronny
NEURONA Vol 38 No 1 (2020)
Publisher : PERDOSNI

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Abstract

Tuberculosis is highly prevalent in developing countries. It is most commonly seen infecting the lungs but can also be found as extrapulmonary tuberculosis (EPTB). Central nervous system (CNS) tuberculosis represented about 10% of EPTB. The primary form of CNS TB is meningitis TB. There are however, other rarer forms, such as tuberculous brain abscess (TBA). Abscesses are more commonly seen in immunocompromised patients. A 19 year old female came with a complaint of headache for 1 week accompanied with recurrent fever, nausea, and vomiting. Physical examination shows nuchal rigidity in the patient. Blood workup revealed that the patient was HIV negative. Primary lung tuberculosis was found in the patient on chest x-ray. On brain MRI abscesses were found. The patient was given anti-tuberculous drug regiment. Follow up brain MRI was performed 2 months after treatment with oral anti-tuberculous therapy 1x3 4 FDC (fixed drug combination). Before treatment, brain MRI with contrast showed two ring enhanced lesions with irregular border on the right cerebellum hemisphere with approximate size 2.8x2.6x1.8 cm (AP x transversal x height) with some satellite nodules and enhancements on right tentorium cerebelli. There’s also another ring enhanced lesion with irregular border on right frontal lobe pre central gyrus with approximate size 1.4x2x1.1 cm (AP x transversal x height) with perifocal oedema. Follow up MRI after oral anti-tuberculous therapy showed decreased in size for both lesions. We documented one case of brain tuberculosis in non HIV patient, which showed significant improvement after given oral anti-tuberculous drugs. Keywords: extrapulmonary tuberculosis, tuberculosis, tuberculous brain abscess