Clinical Images

Calvarial Tuberculosis

Eleni Ischaki*; Eleni Margioula

First Department of Intensive Care Medicine, National and Kapodistrian University of Athens Medical School, Evaggelismos General Hospital, Athens, Greece.

Received Date: 24/12/2021; Published Date: 31/01/2022.

*Corresponding author: Eleni Ischaki, Michali Karaoli str. 39-45, Kaisariani, Athens, Greece. ZC 16121.

A 19-year-old boy presented with status epilepticus. Computed tomography of the brain showed a big, multilobular mass, with peripheral oedema in the frontal lobe which was enhanced peripherally after intravenous administration of a contrast agent. The mass penetrated the frontal bone and extended subcutaneously. He immediately underwent right decompression craniectomy. An empyema was found and was drained. Microscopic examination of brain, dura mater and bone tissue specimens revealed a necrotizing granulomatous inflammation. Tissue cultures were positive for Mycobacterium tuberculosis. The patient received a 4-regimen antitubercular treatment combined with dexamethasone due to central nervous system penetration of the disease with complete response in the follow-up.