Introduction
Prevalence of tuberculosis in developing countries is significantly
higher than developed nations. However, after global AIDS pandemic,
cases of tuberculosis are also raised in developed countries due to
marked increased in number of immunocompromised individual. In general,
patients having tuberculosis is present with low grade fever, prolonged
cough, occasional chest pain, fatigue and significant weight loss.
Extra-pulmonary spread of tuberculosis like tuberculosis of central
nervous system (CNS), especially tuberculous meningitis, is one of the
leading causes of mortality in developing countries like India. The
problem is further aggravated by the increasing prevalence of HIV
infection. [1,2] Tubercular brain abscess (TBA) is a very uncommon
manifestation of CNS tuberculosis. Prevalence of TBA is approximately
4-8% in immunocompetent individual however, in individuals with HIV-TB
co-infection occurrence of TBA is raised up to 20%. [3] TBA may be
unilocular or multilocular and resembles a pyogenic abscess clinically
and radiological, differentiation between this two is challenging.
[4] Patients may present with features of raised intracranial
pressure and focal neurological deficit, depending on the site of the
abscess. [5] CT-scan or MRI of the brain as well as confirming
primary tuberculosis infection is helpful for diagnosing TBA. On the
basis of involvement of brain parenchyma, usually combined medical and
surgery is considered for management of TBA.