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1.
Arch. argent. pediatr ; 120(5): e218-e222, oct. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1395823

ABSTRACT

La tuberculosis es una de las principales causas infecciosas de muerte en el mundo y es endémica en Argentina. La mayoría de los casos de tuberculosis son de localización pulmonar; el tuberculoma una complicación infrecuente. Se describe un caso clínico de presentación pulmonar atípica de tuberculosis. Se trata de una niña de 15 meses, previamente sana, derivada a neumología por fiebre, mal progreso de peso e imagen persistente por 2 meses en la radiografía de tórax a pesar de haber recibido antibioticoterapia. Antecedente de contacto estrecho con persona sintomática respiratoria. Se internó para estudio, mostró una PPD de 13 mm y una masa voluminosa heterogénea en el lóbulo superior izquierdo en la tomografía computada de tórax. Se realizaron tres lavados gástricos y toracoscopia exploratoria con biopsia pulmonar con rescate de Mycobacterium tuberculosis en cultivos. Se diagnosticó tuberculoma pulmonar y realizó tratamiento estándar con fármacos antituberculosos con evolución favorable.


Tuberculosis is one of the main causes of death due to infection around the world. Although tuberculosis frequently involves lung parenchyma, tuberculoma is a rare complication. We describe an atypical pulmonary presentation of tuberculosis. A 15-month-old girl, previously healthy, was referred to the pulmonology department due to fever, poor weight gain, and a 2-months persistent lung image on chest x-ray despite antibiotic therapy. She had been in frequent contact with a respiratory symptomatic subject. She was admitted to the hospital with a TST of 13 mm and a heterogeneous bulky mass in the left upper lobe at chest computed tomography. Three gastric lavages were done and the patient underwent exploratory thoracoscopy and lung biopsy, with positive cultures for Mycobacterium tuberculosis. The diagnosis of pulmonary tuberculoma was confirmed, and the patient received standard anti- tuberculosis therapy with a favorable evolution.


Subject(s)
Humans , Female , Infant , Tuberculoma/pathology , Tuberculosis, Lymph Node , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnosis , Lung/pathology , Anti-Bacterial Agents
2.
Rev. bras. oftalmol ; 80(4): e0017, 2021. graf
Article in English | LILACS | ID: biblio-1288630

ABSTRACT

ABSTRACT Choroidal tuberculomas are present in patients with ocular tuberculosis. They usually occur in a patient with previous history of tuberculosis, and are rarely the initial presentation, with no prior systemic manifestations. We present a patient with unilateral choroidal tuberculoma as the initial presentation of presumed ocular tuberculosis, which enabled earlier initiation of treatment.


RESUMO Os tuberculomas de coroide apresentam-se em pacientes com tuberculose ocular. Geralmente, ocorrem em indivíduos com história prévia de tuberculose e raramente têm apresentação inicial sem manifestações sistêmicas anteriores. Relatamos o caso de um paciente com tuberculoma de coroide unilateral com apresentação inicial de tuberculose ocular presumida, permitindo o início mais precoce do tratamento.


Subject(s)
Humans , Female , Adult , Tuberculoma/diagnosis , Choroid Diseases/diagnosis , Tuberculoma/drug therapy , Fluorescein Angiography , Choroid Diseases/drug therapy , Uveitis, Posterior/diagnosis , Tuberculosis, Ocular , Choroid/diagnostic imaging , Fundus Oculi , Antitubercular Agents/therapeutic use
4.
Arq. bras. neurocir ; 39(2): 142-145, 15/06/2020.
Article in English | LILACS | ID: biblio-1362532

ABSTRACT

Tuberculosis (TB) of the central nervous system (CNS) is considered one of the most severe forms of presentation of the disease. Although only 1% of TB cases involve the CNS, these cases represent around between 5 and 15% of extrapulmonary forms.1,2 Tuberculous meningitis (TBM) is the most frequent form of CNS TB. The granulomas formed in the cerebral tuberculoma may cause hydrocephalus and other symptoms indicative of a CNS mass lesion. In the absence of active TB or TBM, the symptoms may be interpreted as indicative of tumors.3,4 The prognosis is directly related to the early diagnosis and proper treatment installation.5 We report the case of a patient with intracranial hypertension syndrome, expansive mass in the parieto-occipital region, accompanied by a lesion in the rib, initially thought to be a metastatic lesion, although posteriorly diagnosed as a cerebral tuberculoma.


Subject(s)
Humans , Male , Aged, 80 and over , Tuberculoma/diagnosis , Tuberculoma/therapy , Tuberculoma, Intracranial/pathology , Tuberculosis, Central Nervous System , Microsurgery/methods , Antitubercular Agents/therapeutic use
5.
Arq. bras. neurocir ; 38(1): 64-67, 15/03/2019.
Article in English | LILACS | ID: biblio-1362674

ABSTRACT

Meningitis or meningoencephalitis are the most common presentations of Koch bacilli infection on the central nervous system (CNS), especially in immunosuppressed patients, in whom the bacilli normally reaches the meninges and the cerebral parenchyma.. A least common pathological presentation is the tumoral growth pattern disease known as tuberculoma. This pathological entity is more common in the cerebral hemispheres and is rarely located in the brainstem. The present case report describes a case of a 55-year-old patient under regular antiretroviral therapy who was hospitalized with signs of brainstem and cerebellar disturbances. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed an exophytic lesion in the dorsal region of the pons. The patient underwent total resection of the lesion and the histopathologic analysis was consistent with a tuberculoma.


Subject(s)
Humans , Male , Middle Aged , Tuberculoma/pathology , Tuberculosis, Meningeal/diagnosis , Tuberculosis, Meningeal/therapy , Brain Stem/pathology , Immunocompromised Host
6.
Article in Korean | WPRIM | ID: wpr-764824

ABSTRACT

Nearly one third of the world's population have active or latent tuberculosis, resulting in 1.5 million deaths annually. Tuberculosis involving the peripheral nerve is difficult to detect. Sural nerve tuberculoma is an extremely rare case of tuberculous involvement of the peripheral nerve that has attracted the attention of physicians. This paper reports a patient with sural nerve tuberculoma. A 58-year-old female patient presented with a palpable mass on the posterolateral calf with progressive tingling sensation on the distal area. The patient had no history of trauma and it was unclear whether the patient had any contact with individuals with active tuberculosis. The histopathologic findings revealed a granuloma-like lesion with caseous necrosis that was compatible with tuberculoma.


Subject(s)
Female , Humans , Latent Tuberculosis , Middle Aged , Necrosis , Peripheral Nerves , Sensation , Sural Nerve , Tuberculoma , Tuberculosis
7.
Article in English | WPRIM | ID: wpr-739663

ABSTRACT

Idiopathic granulomatous hypophysitis (IGH), a rare disease, requires differentiation from more common mass lesions of the sella such as pituitary adenoma, craniopharyngioma, Rathke's cleft cyst, or pituitary tuberculoma. IGH usually presents with an insidious onset of visual defects and headaches. On the other hand, rapid onset of neurologic and visual symptoms in an IGH patient is exceptionally rare. Here, we present a biopsy-proven case of IGH with rapid onset and satisfactory outcome after high dose steroid treatment.


Subject(s)
Adult , Autoimmune Hypophysitis , Craniopharyngioma , Endoscopy , Glucocorticoids , Hand , Headache , Humans , Pituitary Gland , Pituitary Neoplasms , Rare Diseases , Sella Turcica , Tuberculoma
8.
Rev. argent. cir ; 110(4): 211-214, dic. 2018. ilus
Article in Spanish | LILACS | ID: biblio-985192

ABSTRACT

La preocupación por los trastornos intestinales y la oclusión, como consecuencia de la formación de bridas peritoneoviscerales producidas por gestos quirúrgicos manuales e instrumentales, ha dado lugar a procedimientos con miras a evitarlas o minimizarlas. En este marco, la técnica de mesenteroplicatura con sostén transitorio tiene el propósito de favorecer el ordenamiento fibrointestinal, cuando la patología tratada haga sospechar que se producirán adherencias y más aún si la intervención ha sido causada por estas. Los fundamentos del procedimiento son los mismos que sostienen las técnicas usuales, por lo tanto no hay controversias en cuanto a las indicaciones. La lógica de la sutura transitoria está en que el tutor pierde su objetivo y se retira cuando finaliza el proceso adherencial, alrededor de las dos semanas de la intervención. Se presentan tres casos de oclusión intestinal operados con el procedimiento, controlados y con buenos resultados.


Peritoneal adhesions produced as a consequence of manual or instrumental manipulation during surgery cause bowel obstruction. Several procedures have been developed to avoid or minimize adhesions. Mesenteric plication with temporary suture support organizes the healing process in the bowel in case of high suspicion of adhesions will develop, particularly when bowel obstruction is produced by adhesions. The basis of this technique is the same as for standard procedures and, thus, there are no controversies about its indications. The rationale of temporary suture support is that when the healing process is over, about two weeks after the intervention, the suture support is no longer needed. We report three cases of intestinal obstruction undergoing mesenteric plication and temporary suture support, with favorable outcomes.


Subject(s)
Humans , Male , Adult , Middle Aged , Young Adult , Surgical Procedures, Operative/methods , Intestinal Obstruction/surgery , Tuberculoma/diagnosis , Peritonitis, Tuberculous/surgery , Tuberculosis, Pulmonary/diagnosis , Colectomy/methods , Cholecystitis, Acute , Abdomen, Acute/surgery
9.
Rev. am. med. respir ; 18(3): 201-204, set. 2018. ilus
Article in Spanish | LILACS | ID: biblio-977174

ABSTRACT

Hasta en un 25% de los casos de tuberculosis (TB) existe compromiso extrapulmonar. La afectación de sistema nervioso central ocurre en 5-10% de las formas extrapulmonares de tuberculosis. El cuadro más frecuente es la meningitis aunque también pueden producirse tuberculomas. El compromiso de órganos otros que los pulmones se debe a la diseminación hematógena y linfática del bacilo de Mycobacterium tuberculosis. Los pacientes con TB y serología positiva para VIH tienen cinco veces más probabilidades de tener compromiso del sistema nervioso central (SNC), como resultado de diseminación hematógena del bacilo desde un foco distal que evoluciona formando pequeños focos cerebrales. Los tuberculomas del SNC, por su capacidad de simular otras lesiones y por su incidencia en países en vías de desarrollo, deben incluirse siempre en la lista de diagnósticos diferenciales. A pesar del auge y el avance de las técnicas diagnósticas, el cultivo sigue siendo el estándar de oro que permite el diagnóstico microbiológico definitivo


Subject(s)
Tuberculoma , Central Nervous System
10.
Article in English | WPRIM | ID: wpr-787084

ABSTRACT

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a 1.5×1.3 cm homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a 0.5×0.4 cm round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.


Subject(s)
Adenoma, Pleomorphic , Asthma , Bronchi , Cough , Diagnosis , Dyspnea , Humans , Lymph Nodes , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive , Recurrence , Salivary Glands , Thorax , Trachea , Tracheal Neoplasms , Tuberculoma , Tuberculosis, Pulmonary
11.
Rev. colomb. cir ; 33(3): 307-310, 2018. fig
Article in Spanish | LILACS, COLNAL | ID: biblio-915813

ABSTRACT

La tuberculosis es una de las enfermedades infecciosas más frecuentes de distribución mundial, con una amplia presentación clínica. La afectación hepática de la tuberculosis es poco frecuente, pero más infrecuente aún lo es el tuberculoma hepático. Se presenta el caso de una paciente con tuberculoma hepático solitario que simula metástasis hepática secundaria a tumor neuroendocrino


Tuberculosis is one of the most common infectious diseases, with worldwide distribution and ample clinical manifestations. Hepatic tuberculosis is rare but hepatic tuberculoma is even rarer. We report an unusual case of a solitary hepatic tuberculoma simulating hepatic metastasis of a neuroendocrine tumor


Subject(s)
Humans , Mycobacterium tuberculosis , Tuberculoma , Tuberculosis, Hepatic , Focal Nodular Hyperplasia
12.
Article in English | WPRIM | ID: wpr-193196

ABSTRACT

Tuberculosis can occur in various organ systems and may present with diverse manifestations. We report an unusual case of mediastinal tuberculoma in a 3-month-old boy who presented to the hospital after experiencing fever, cough, and progressive pneumonia for two weeks. The chest computed tomography scan indicated a mediastinal mass suggesting lymphoma. However, histological analysis confirmed that the mass was caused by tuberculosis. The present report describes the delayed diagnosis of a disease due to an uncommon presentation. Misdiagnosing unusual cases of tuberculosis results in treatment delays and may lead to an increase in morbidity. Therefore, we suggest that tuberculosis should be included in the differential diagnosis for children presenting with a mediastinal mass, especially in areas with a high prevalence of tuberculosis.


Subject(s)
Child , Cough , Delayed Diagnosis , Diagnosis, Differential , Fever , Humans , Infant , Lymphoma , Male , Mediastinum , Pneumonia , Prevalence , Thorax , Tuberculoma , Tuberculosis
13.
Article in Korean | WPRIM | ID: wpr-765868

ABSTRACT

No abstract available.


Subject(s)
Brain , Tuberculoma
14.
Acta méd. colomb ; 41(2): 141-143, abr.-jun. 2016. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-949499

ABSTRACT

Resumen Se describe el caso de un paciente masculino de 35 años de edad, que se presenta con un tuberculoma intramedular torácico, con diagnóstico de VIH (Virus de la inmunodeficiencia humana) de seis años de evolución y dos meses antes TB (tuberculosis) pulmonar; su manejo médico y HAART (terapia antirretroviral altamente efectiva) sin adecuada adherencia. Se describe la contribución al diagnóstico de la RM (resonancia magnética), en la cual se visualiza área de mielitis focal en T10 que se marca intensamente con el medio de contraste, imagen que sugiere infección por TB. El tuberculoma intramedular es raro, pero debe ser considerado como diagnóstico diferencial de síntomas compresivos medulares en pacientes infectados por VIH, de evolución no clara y estudios del líquido cefalorraquídeo negativos. (Acta Med Colomb 2016; 41: 141-143).


Abstract The case of a 35 years old male patient with a thoracic intramedullary tuberculoma, with diagnosis of HIV (Human Immunodeficiency Virus) of six years of evolution and of pulmonary TB (tuberculosis) two months before, is presented; he had medical management and HAART (highly effective anti retroviral therapy) without proper adhesion. The contribution of MRI (magnetic resonance imaging) to the diagnosis, in which an image of focal area of myelitis in T10 intensely marked with contrast medium, suggests TB infection, is described. The intramedullary tuberculoma is rare, but should be considered as a differential diagnosis of symptoms of spinal cord compression in HIV-infected patients with no clear evolution and negative cerebrospinal fluid studies. (Acta Med Colomb 2016; 41: 141-143).


Subject(s)
Humans , Male , Adult , Tuberculoma , Tuberculosis , Magnetic Resonance Spectroscopy , Central Nervous System
15.
Article in English | WPRIM | ID: wpr-125895

ABSTRACT

No abstract available.


Subject(s)
Stroke , Tuberculoma
16.
Article in English | WPRIM | ID: wpr-82804

ABSTRACT

In Korea, tuberculosis is still common disease. Central nervous system tuberculosis can manifest in a variety of forms, including tuberculous meningitis, tuberculous cerebritis, tuberculoma, tuberculous abscess, and miliary tuberculosis. Although intra-axial tuberculomas are the more common type of CNS tuberculosis, extra-axial lesions are rarely encountered. En plaque tuberculoma is an extremely rare presentation of intracranial tuberculosis with mimicking primary or secondary meningeal neoplasia. We describe a rare case of an en plaque tuberculoma accompanied by tuberculous meningitis and tuberculomas.


Subject(s)
Abscess , Korea , Magnetic Resonance Imaging , Tuberculoma , Tuberculosis , Tuberculosis, Central Nervous System , Tuberculosis, Meningeal , Tuberculosis, Miliary
17.
Korean Journal of Spine ; : 99-102, 2015.
Article in English | WPRIM | ID: wpr-182513

ABSTRACT

Spinal intramedullary tuberculoma remains a very rare entity of central nervous system tuberculosis. This is the same with the coexistence of spinal intramedullary and intracranial tuberculomas that remains extremely rare with less than 20 cases reported at present. Authors describe this uncommon case by analyzing a 65-year-old female patient who had past history of kidney transplantation due to stage 5 chronic kidney disease and pulmonary tuberculosis on medication. The patient experiences progressive paraplegia and numbness on both lower extremities. Magnetic resonance imaging demonstrated an intramedullary mass at T9-10 level and multiple intracranial enhancing nodules. Microsurgical resection of spinal intramedullary mass was performed and the lesion was histopathologically confirmed as Mycobacterium tuberculosis. Efficient diagnosis and management of this rare disease are reviewed along with previously reported cases.


Subject(s)
Aged , Diagnosis , Female , Humans , Hypesthesia , Kidney Transplantation , Lower Extremity , Magnetic Resonance Imaging , Mycobacterium tuberculosis , Paraplegia , Rare Diseases , Renal Insufficiency, Chronic , Tuberculoma , Tuberculoma, Intracranial , Tuberculosis, Central Nervous System , Tuberculosis, Pulmonary
18.
Korean Journal of Spine ; : 107-110, 2015.
Article in English | WPRIM | ID: wpr-182511

ABSTRACT

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.


Subject(s)
Adult , Arachnoid , Female , Humans , Magnetic Resonance Imaging , Paraplegia , Spinal Cord , Syringomyelia , Tuberculoma , Tuberculosis, Meningeal
19.
Article in English | WPRIM | ID: wpr-224783

ABSTRACT

We report a case of a paradoxical response of a tuberculoma in the brain mimicking a brain tumor. A 76-year-old woman presented with a 2 week history of headache, dysarthia, and orthopnea. Brain magnetic resonance images (MRI) revealed two rim-enhancing lesions on the pons and occipital lobe, and chest computed tomography showed randomly distributed miliary nodules. The tentative diagnosis was tuberculosis (TB) of the brain and lung. She complained of right hemiparesis and worsening general weakness after taking the anti-TB medication. On the monthly follow-up images, the enhanced lesions were enlarged with increased perfusion and choline/creatinine ratio, suggesting a high grade glioma. A surgical resection was completed to diagnose the occipital lesion, and the tuberculoma was pathologically confirmed by a positive TB-polymerase chain reaction. The anti-TB medication was continued for 13 months. A follow-up MRI showed decreased size of the brain lesions associated with perilesional edema, and the clinical symptoms had improved. Brain tuberculoma could be aggravated mimicking brain malignancy during administration of anti-TB medication. This paradoxical response can be effectively managed by continuing the anti-TB drugs.


Subject(s)
Aged , Brain , Brain Neoplasms , Diagnosis , Edema , Female , Follow-Up Studies , Glioma , Headache , Humans , Lung , Magnetic Resonance Imaging , Occipital Lobe , Paresis , Perfusion , Pons , Thorax , Tuberculoma , Tuberculosis
20.
Article in English | WPRIM | ID: wpr-60925

ABSTRACT

OBJECTIVE: Spinal intramedullary tuberculoma (SIMT) is rare, accounting for 2/100,000 cases of tuberculosis and only 0.2% of all cases of central nervous system(CNS) tuberculosis. We share our experiences of 11 cases of this entity for improving diagnosis and conceptualize the management of this rare disease. METHODS: The clinical profile, radiological data and management of 11 cases of SIMT which were managed either conservatively or by surgical intervention during last 27 years (1987-2014) were analysed. RESULTS: Male:female ratio was 1.75:1. Five cases had associated pulmonary Koch's. Most common site was thoracic cord. Two cases had concurrent multiple intracranial tuberculoma. Most common presentation was paraparesis. X-ray myelography was performed in two patients in the initial period of study suggesting intramedullary pathology. In the subsequent nine cases who had magnetic resonance imaging (MRI), seven showed typical "target sign" and conglomerate ring lesion. Out of 8 surgically managed patients, 6 cases improved rapidly and in 2 patients gradual improvement was seen in follow-up. Most common indication of surgical excision was rapid neurological deterioration followed by diagnosis in doubt. Histopathology confirmed tuberculous etiology of the intramedullary lesion in all. Clinical and radiological improvement was seen in all 3 conservatively managed patients in follow-up. CONCLUSION: MRI findings of SIMT were specific and proven histologically correct. Surgical intervention may be indicated if there is no response to chemotherapy, the diagnosis is in doubt, or there is a rapid deterioration in neurological function because surgical outcome is good in these circumstances.


Subject(s)
Diagnosis , Drug Therapy , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Myelography , Paraparesis , Pathology , Rare Diseases , Tuberculoma , Tuberculoma, Intracranial , Tuberculosis
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