Disseminated tuberculosis
Discussion:
Miliary pulmonary TB in combination with multiple tuberculomas in the brain and spine is a very rare condition. The prevalence of intramedullary tuberculoma has been reported in 1-2/100,000 patients with tuberculosis 1.
Presence of Mycobacterium tuberculosis was confirmed by PCR from broncho-alveolar lavage (BAL).
Tuberculomas are not to be confused with tuberculous abscesses which are far more uncommon. Abscesses are more associated with restricted diffusion in the core and more prominent perifocal edema. The multiplicity and small size of the lesions as in this case favor a diagnosis of tuberculomas.
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