Tuberculous brain abscess mimicking metastatic disease
- 1State Key Laboratory of Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR China
- 2Department of Pathology, Kwong Wah Hospital, Kowloon, Hong Kong SAR China
Abstract
An 85-year-old, HIV-seronegative woman presented with subacute right-sided weakness and dysarthria. Neuroimaging revealed multiple rim-enhancing intracranial mass lesions, initially attributed to metastatic disease of unknown primary. Subsequent biopsy and excision yielded purulent material with abundant acid-fast bacilli; culture and molecular testing confirmed Mycobacterium tuberculosis. Histopathology demonstrated an exceptionally high mycobacterial burden and an absence of well-formed epithelioid granulomas, establishing a diagnosis of tuberculous brain abscess. A 12-month anti-tuberculosis therapy led to clinical and radiological resolution. This case illustrates an uncommon presentation of central nervous system tuberculosis that can closely mimic intracranial malignancy.
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BibTeX
@article{lee2026tuberculous,
title = {{Tuberculous brain abscess mimicking metastatic disease}},
author = {Anson Chung-Ho Lee and Wing-Sze Tong},
journal = {Infection},
year = {2026},
month = aug,
doi = {10.1007/s15010-026-02916-6},
url = {https://doi.org/10.1007/s15010-026-02916-6},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Tuberculous brain abscess mimicking metastatic disease
AU - Anson Chung-Ho Lee
AU - Wing-Sze Tong
PY - 2026
DA - 2026/08/11
JO - Infection
DO - 10.1007/s15010-026-02916-6
UR - https://doi.org/10.1007/s15010-026-02916-6
AB - An 85-year-old, HIV-seronegative woman presented with subacute right-sided weakness and dysarthria. Neuroimaging revealed multiple rim-enhancing intracranial mass lesions, initially attributed to metastatic disease of unknown primary. Subsequent biopsy and excision yielded purulent material with abundant acid-fast bacilli; culture and molecular testing confirmed Mycobacterium tuberculosis. Histopathology demonstrated an exceptionally high mycobacterial burden and an absence of well-formed epithelioid granulomas, establishing a diagnosis of tuberculous brain abscess. A 12-month anti-tuberculosis therapy led to clinical and radiological resolution. This case illustrates an uncommon presentation of central nervous system tuberculosis that can closely mimic intracranial malignancy.
SN - 0300-8126
SN - 1439-0973
ER -