Cerebral Tuberculoma in a Lung Transplant Patient

Abstract

The risk of infection caused by Mycobacterium tuberculosis in transplanted patients increases 20-74 times compared to general population, with an incidence in Spain from 0, 4-0, 8%, and is higher in lung transplant patients. Almost 50% of the tuberculosis cases might be disseminated. The infection of central nervous system (CNS) is not common, less than 1%, presenting as meningitis, tuberculomas or cerebral abscess. We present a 55 years old patient with a diagnosis of lung tuberculosis 40 months after lung transplantation. One month later, he started with neurologic symptoms and persistent fever, with radiologic findings compatible with cerebral tuberculomas. Corticoid therapy was added to tuberculostatic treatment. One month later, he presented seizures that were controlled with anticonvulsant treatment. In every transplanted patient with space occupying lesions in central nervous system and infectious symptoms cerebral tuberculosis must be suspected like one possible diagnosis.