ABSTRACT
Worldwide, around 10 million people fall sick every year because of Tuberculosis (TB). In India, the incidence is 2.69 million cases. Central nervous system Tuberculosis (CNS TB), which is one of the most deadly forms of tuberculosis (TB) mainly manifests as TB Meningitis followed by Tuberculoma, Tubercular abscess and other forms. CNS TB is seen in 5 to 10% of extra-pulmonary TB cases, and accounts for 1% of all TB cases and has the highest mortality. They usually present with symptoms such as headache and seizures. They may have other signs and symptoms based on the size and the location of the lesions. The advent of modern technology such as CT, MRI scans helped to diagnose early. Diagnosis is established by CT/MRI Brain, where a granulomatous lesion with/without perilesional edema is seen. MR Spectroscopy brain is indicated when the diagnosis is doubtful. Presence of lipid peak on MR Spectroscopy is diagnostic of CNS Tuberculomas. Medical management is adequate and there is no role for surgery. A course of ATT for 6 months along with corticosteroids is adequate. Addition of corticosteroids is necessary to reduce the paradoxical response; it also reduces the size of the lesion and perilesional edema. Anti epileptic drugs are not necessary. CNS Tuberculoma is curable if treated properly.
ABSTRACT
Kartagener?s syndrome is a rare disorder. The estimated prevalence of Kartagener?s syndrome is about 1 in 30,000. It is autosomal recessive ciliary disorder comprising the triad of situs inversus totalis, chronic sinusitis, and bronchiectasis. There is a defective movement of cilia, which leads to recurrent respiratory infections, and ear/ nose/ throat infections, and infertility. We hereby report a rare case of Kartagener?s syndrome, an infertile male with azoospermia. The clinician should have a high index of suspicion, so as to make an early diagnosis. An early diagnosis helps in such patients so that the options for timely treatment of infertility may be offered and unnecessary evaluation is avoided.