Tuberculosis is an infectious disease whose incidence has increased because of HIV and immunosuppressive drugs ^1-6. Pulmonary Miliary tuberculosis should be a warning for investigation of CNS tuberculosis, especially in immunocompromised patients ^1-6. Brain tuberculomas with central liquefaction and tuberculous abscess are indistinguishable on MRI, and they also have a similar appearance with pyogenic cerebral abscesses ^2,3,5. Early diagnosis is essential and determines the clinical outcomes; therefore, radiologists must be familiar with the various imaging presentations of tuberculosis ^1-5.

This case demonstrates classic pulmonary miliary tuberculosis with CNS tuberculosis, confirmed by clinical, chest CT images, brain MRI and CSF criteria.

Case courtesy

• Isabela Oliveira, MD – PGY-2, radiology resident, Department of Radiology
• Rennah Gonçalves, MD – PGY-3, radiology resident, Department of Radiology
• Antonio Rodrigues de Aguiar Neto, MD - radiologist, Department of Radiology

Hospital da Restauração – Recife, PE – Brazil