What the study found
The report describes a biopsy-proven case of isolated central nervous system tuberculosis (TB) in a 76-year-old woman with progressive encephalopathy. The diagnosis was confirmed only after an open meningeal biopsy showed necrotizing granulomas with acid-fast bacilli.
Why the authors say this matters
The authors conclude that central nervous system TB can be difficult to recognize because its clinical and radiologic features are often nonspecific and can resemble malignancy, inflammatory disorders, or fungal infections. They also state that early recognition is important for timely treatment and improved neurologic outcomes.
What the researchers tested
This is a case report of one patient who presented after travel to Ghana with a six-month history of progressive encephalopathy. The evaluation included cerebrospinal fluid testing, neuroimaging, empiric antituberculous therapy, and an open meningeal biopsy for definitive diagnosis.
What worked and what didn't
Initial neuroimaging was unrevealing, and routine meningitis testing was negative. Cerebrospinal fluid analysis showed lymphocytic pleocytosis and markedly low glucose, later brain magnetic resonance imaging showed diffuse nodular leptomeningeal enhancement, and the patient improved clinically and radiologically with antituberculous therapy and adjunctive corticosteroids.
What to keep in mind
The available summary describes a single patient, so the findings are limited to this case. The abstract also notes that conventional cerebrospinal fluid testing has limited sensitivity and that no evidence of pulmonary TB was identified in this patient.
Key points
- A 76-year-old woman was diagnosed with isolated central nervous system TB after open meningeal biopsy.
- Her presentation included six months of progressive encephalopathy after travel to Ghana.
- Routine meningitis testing was negative, and the first neuroimaging study was unrevealing.
- Cerebrospinal fluid showed lymphocytic pleocytosis and very low glucose.
- Brain MRI later showed diffuse nodular leptomeningeal enhancement involving the posterior fossa and brainstem.
- The patient improved with antituberculous therapy and adjunctive corticosteroids.
Disclosure
- Research title:
- Biopsy confirmed isolated central nervous system tuberculosis in progressive encephalopathy
- Authors:
- Linnet Leon Chaviano, Leen Daghir, Rawan Zeizzoun, Amer Zeizoun, Indulekha Gopal
- Institutions:
- Ain Shams University, Broward Health, Broward Health, Broward Health, Broward Health
- Publication date:
- 2026-06-28
- OpenAlex record:
- View
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