Granulomatous disease was suggested on the basis of the intracranial and bone appearances and TB was the primary suspect. Lesions on the lower limbs were compatible with erythema nodosum.

Histopathology:

Stereotactic craniotomy and biopsy of right parietal lesion: Necrotizing granulomatous inflammation within cortex, occasional auramine fluorescent rod-shaped bacteria present suspicious for mycobacteria.

Skin excision subcutaneous lesion of back: Necrotizing granulomatous inflammation.

Right middle finger biopsy - inflamed granulation tissue and multiple well-formed granulomas with areas of necrosis, few microorganisms suspicious for mycobacteria noted.

EBUS of mediastinal lymph node: granulomata.

Final diagnosis: Multi-drug resistant TB which resolved on treatment.