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Peer-reviewedCC BYCase reports in neurological medicine

Cerebral Manifestation of Miliary Tuberculosis Mimicking a Parasitic CNS Infection.

  • Daniel Martens1,2
  • Fatma Merzou1,2
  • Nils Schroeter1,2
  • Malvina Garner3
  • Wolfgang Reith3
  • Sergiu Groppa1,2
  • Yaroslav Winter1,2,4
4 affiliations
  1. 1Department of Neurology Saarland University Homburg Germany uni-saarland.de.
  2. 2Department of Neurology Saarland University Medical Center Homburg Germany uniklinikum-saarland.de.
  3. 3Department of Neuroradiology Saarland University Medical Center Homburg Germany uniklinikum-saarland.de.
  4. 4Department of Neurology Philipps-University Marburg Marburg Germany uni-marburg.de.
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Abstract

The neuroradiological findings of central nervous system (CNS) manifestations of miliary tuberculosis can be misinterpreted as parasitic infections due to their low prevalence in the European population. We present the case of a 30-year-old woman in whom CNS tuberculosis was initially misdiagnosed as a parasitic infection due to the absence of pulmonary symptoms. She immigrated to Germany from Madagascar and had lived in Europe for 14 months by the time she presented to our department with an incidental MRI finding suggestive of a manifestation of toxoplasmosis. The T1-weighted axial brain MRI scan revealed multifocal, rim-enhancing lesions that were suggestive of parasitic infection. Following a chest CT scan that revealed miliary tuberculosis, the diagnosis was revised to neurotuberculosis. This was confirmed by a polymerase chain reaction (PCR) that detected the Mycobacterium tuberculosis complex in the sputum sample. The patient achieved remission following 12 months of antituberculosis therapy. In conclusion, neurotuberculosis should be considered in the differential diagnosis of infections presenting with multifocal CNS manifestations on neuroimaging scans in European patients, particularly those with a migration background.

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Cite

BibTeXRIS
BibTeX
@article{martens2026cerebral,
  title = {{Cerebral Manifestation of Miliary Tuberculosis Mimicking a Parasitic CNS Infection.}},
  author = {Daniel Martens and Fatma Merzou and Nils Schroeter and Malvina Garner and Wolfgang Reith and Sergiu Groppa and Yaroslav Winter},
  journal = {Case reports in neurological medicine},
  year = {2026},
  month = oct,
  doi = {10.1155/crnm/9275005},
  url = {https://europepmc.org/article/MED/42871258},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cerebral Manifestation of Miliary Tuberculosis Mimicking a Parasitic CNS Infection.
AU  - Daniel Martens
AU  - Fatma Merzou
AU  - Nils Schroeter
AU  - Malvina Garner
AU  - Wolfgang Reith
AU  - Sergiu Groppa
AU  - Yaroslav Winter
PY  - 2026
DA  - 2026/10/12
JO  - Case reports in neurological medicine
DO  - 10.1155/crnm/9275005
UR  - https://europepmc.org/article/MED/42871258
AB  - The neuroradiological findings of central nervous system (CNS) manifestations of miliary tuberculosis can be misinterpreted as parasitic infections due to their low prevalence in the European population. We present the case of a 30-year-old woman in whom CNS tuberculosis was initially misdiagnosed as a parasitic infection due to the absence of pulmonary symptoms. She immigrated to Germany from Madagascar and had lived in Europe for 14 months by the time she presented to our department with an incidental MRI finding suggestive of a manifestation of toxoplasmosis. The T1-weighted axial brain MRI scan revealed multifocal, rim-enhancing lesions that were suggestive of parasitic infection. Following a chest CT scan that revealed miliary tuberculosis, the diagnosis was revised to neurotuberculosis. This was confirmed by a polymerase chain reaction (PCR) that detected the Mycobacterium tuberculosis complex in the sputum sample. The patient achieved remission following 12 months of antituberculosis therapy. In conclusion, neurotuberculosis should be considered in the differential diagnosis of infections presenting with multifocal CNS manifestations on neuroimaging scans in European patients, particularly those with a migration background.
SN  - 2090-6668
SN  - 2090-6676
ER  -