# Tuberculosis: Cliché or Outsider?

## TL;DR

This paper discusses a rare case of tuberculosis affecting the brain in a 34-year-old woman, highlighting the challenges of diagnosing the disease in Portugal.

## Contribution

The novelty lies in presenting a rare clinical presentation of cerebral tuberculomas and miliary tuberculosis in a Portuguese context.

## Key findings

- A 34-year-old female was diagnosed with cerebral tuberculomas and miliary tuberculosis.
- Neurologic deficits resolved after starting antibacillary therapy.
- The case is considered rare in Portugal despite being a common presentation elsewhere.

## Abstract

Tuberculosis is an infectious disease with the potential for multisystemic dissemination, including the central nervous system (CNS). It is difficult to diagnose when the central nervous system is involved. Brain biopsy is the diagnostic method par excellence for diagnostic confirmation; however, as it is an invasive method and therefore not free from risks, before carrying it out, extra-CNS sites should be privileged, whenever available, through mycobacteriological culture.

Here, we present a case of a 34-year-old female with chronic onset of neurologic semiology, whose diagnostic evolution culminated in the diagnosis of cerebral tuberculomas and miliary tuberculosis. Rapid commencement of antibacillaty therapy led to the resolution of the neurologic deficits. Although we face a cliché clinical presentation, in the sense that is very common, the authors consider it outsider because such a presentation is rarely seen in Portugal.