Numerous Asymptomatic Brain Tuberculomas Complicated by Fatal Tuberculous Meningitis

TL;DR

A man had many brain TB growths without symptoms before dying from TB meningitis, highlighting a rare and dangerous TB progression.

Contribution

The case highlights the rare occurrence of asymptomatic multiple brain tuberculomas progressing to fatal meningitis.

Findings

A 55-year-old man had at least 34 asymptomatic brain tuberculomas before developing tuberculous meningitis.

The case suggests possible public health challenges that may have influenced the clinical course.

The report emphasizes the need to consider non-traditional factors in CNS-TB research.

Abstract

Tuberculosis (TB) is still one of the most challenging infectious diseases worldwide. Coinfection with HIV increases the likelihood of extrapulmonary involvement, including the tuberculosis of the central nervous system (CNS-TB). CNS-TB often presents as tuberculomas or tuberculous meningitis. Although tuberculomas can be single or multiple, asymptomatic carriage of numerous tuberculomas is seldom reported. We present a case of a 55-year-old man who carried at least 34 tuberculomas of different sizes asymptomatically before developing and succumbing to tuberculous meningitis. Furthermore, we highlight several possible public health challenges that might have complicated his clinical course, suggesting that future studies also focus on these variables alongside more traditional clinical issues.

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