RESUMO
We report eight cases of brain tuberculoma. The clinical presentation was polymorphous: partial epilepsy (n=4), headache (n=3), hemiplegia (n=1), meningitis (n=1), cerebellar syndrome (n=1). Six patients also had pulmonary tuberculosis, one had tuberculosis of the genital organs, and one had HIV co-infection. The brain CT scan and MRI were highly contributive to diagnosis and follow-up. Despite good compliance with an anti-tuberculosis regimen for at least 14 months, the course was favorable in only six patients. Adjunction of corticosteroids led to radiological improvement. Assessment of cell immunity demonstrated a diminished immunomodulator ratio. Cerebral tuberculoma should be searched for in patients with unexplained neurological manifestations and several intracerebral lesions, particularly if pulmonary or visceral tuberculosis and/or immunodepression is part of the clinical picture.
Assuntos
Tuberculoma Intracraniano/patologia , Corticosteroides/uso terapêutico , Adulto , Feminino , Infecções por HIV/complicações , Humanos , Imunidade Celular/imunologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologia , Tomografia Computadorizada por Raios X , Tuberculoma Intracraniano/tratamento farmacológico , Tuberculoma Intracraniano/imunologia , Tuberculose dos Genitais Masculinos/complicações , Tuberculose dos Genitais Masculinos/imunologia , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/imunologiaRESUMO
Orificial tuberculosis is a rare form of cutaneous tuberculosis. It happens mainly in immunocompromised patients and is characterized by rapidly ulcerating papules in the orifices, including oropharynx or anus, due to autoinoculation of internal tuberculosis. It is a symptom of advanced underlying disease. Kaposi's sarcoma occurs more frequently with the increase of HIV-infected patients. We report on an HIV-negative individual who developed rapid-deteriorating orificial tuberculosis concomitant with Kaposi's sarcoma and had a fatal outcome.