Central nervous system and ovarian tuberculosis an unusual association: a case report

Abstract

Tuberculosis has emerged as one of the major causes of death worldwide. The areas of localizations are varied, with the most common being the lungs. Tuberculosis is associated with decreased immunity. However, with the increase in international trade, promiscuity, poverty, and malnutrition, we are witnessing the rising occurrence of tuberculosis with atypical localization among Human Immunodeficiency Virus (HIV)-negative patients. This paper reports the case of an HIV-negative female who presented with a headache, fever, and multiple episodes of vomiting, and was diagnosed with miliary brain tuberculoma. Magnetic Resonance Imaging (MRI) revealed supra and infra-tentorial tuberculoma and a right occipital abscess. While undergoing anti-tuberculous chemotherapy, she developed a tuberculous ovarian abscess and cervico-thoracic epiduritis. She underwent surgery for the occipital abscess, including abdominopelvic exploration. After 3 months of follow-up, she improved with a good recovery of motor function. However, the follow-up MRI showed the resorption of cerebral miliary tuberculosis with the appearance of a thoracolumbar syrinx as sequelae. Central nervous system and gynecological localization of tuberculosis is rare. However, Mycobacterium Tuberculosis pathophysiology explain this unusual association. Clinicians must be aware to avoid the complications such as disability and infertility.