Dika Chandra Bintari, - and Djohan Ardiansyah, - and Paulus Sugianto, - (2021) Mycobacterium tuberculosis Infection in the Central Nervous System Mimicking Metastatic Process. Annals of the Romanian Society for Cell Biology, 25 (6). pp. 20360-20365. ISSN 1583-6258

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Abstract

Mycobacterium tuberculosis (MTB) infection is a global health issue. Tuberculosis (TB) on the central nervous system (CNS) is a severe form of the disease which entails mortality rate of 15-40%. CNS TB infection results from lymphohematogenous spread and could mimic metastases, thus, diagnosis often becomes difficult. Microbiology and histology examinations are very important for the diagnosis to be made. In this article, we report a 29-year-old immunocompetent male patient with atypical extra-pulmonary TB. Magnetic resonance imaging (MRI) results showed multiple lesions in the brain parenchym, duramater, calvaria and vertebrae, which mimics the metastatic process. Granulomatous lesions and MTB were found through the fine needle aspiration biopsyand histopathological examination. The present of MTB was also confirmed with the GeneExpert examination. In conclusion, establishing a definite diagnosis for multiple CNS TB that mimics metastasis is difficult. Beside from clinical manifestation and radiology, histopathology analysis have an important role in establishing a diagnosis in this case. Detection of MTB bacteria on culture is a gold standard to diagnose TB. Treatment of multiple CNS TB should consist of oral anti tuberculous (OAT) category 2.

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