The successful surgical management of a rare case of infratentorial tubercular abscess in an immunocompetent pediatric patient

Abstract

Tuberculosis (TB) is a chronic infectious disease commonly diagnosed in developing countries. Even though it is a disease primarily affecting the lungs, it can occur in most of the organs of the body. When it affects the central nervous system (CNS), it can result in various neurological sequelae and even death due to increased intracranial pressure. While supratentorial tubercular lesions are relatively common, the disease affecting the infratentorial compartment is very rare, that too in an immunocompetent pediatric patient. Here we report the case of a 5-year-old boy who presented with features of raised intracranial pressure and was diagnosed to have a cerebellar lesion causing hydrocephalus. An emergency surgical decompression was performed and the histopathological examination revealed that the lesion was suggestive of tubercular abscess. The postoperative scan revealed adequate decompression of the lesion with no adverse events and resolution of hydrocephalus. The child recovered without any neurological deficits and anti-tuberculous treatment was continued for one year, but was subsequently lost to follow-up. The successful surgical treatment of a tubercular abscess at a rare location is described.