Isoniazid-resistant intracranial tuberculoma treated with a combination of moxifloxacin and first-line anti-tuberculosis medication
| Autor: | Hiten Thaker, Wha-Yong Lee, Shailendra Achawal, Gavin Anderson, Mirella Ling |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Pathology Tuberculosis Biopsy Moxifloxacin Antitubercular Agents Intracranial Neoplasm Microbiology Young Adult Drug Resistance Bacterial Tuberculosis Multidrug-Resistant medicine Isoniazid Humans Ethambutol Cerebrospinal Fluid Aza Compounds business.industry Histocytochemistry Brain General Medicine Mycobacterium tuberculosis Pyrazinamide bacterial infections and mycoses medicine.disease Magnetic Resonance Imaging Treatment Outcome Tuberculoma Intracranial Quinolines Tuberculoma Female Radiology Headaches medicine.symptom Rifampin business Tomography X-Ray Computed Rifampicin medicine.drug Fluoroquinolones |
| Zdroj: | Journal of medical microbiology. 60(Pt 10) |
| ISSN: | 1473-5644 |
| Popis: | We report a case of a previously healthy 23-year-old Somalian care assistant. She presented with a 4 month history of persistent occipital headaches associated with intermittent nausea and vomiting. Computed tomography and magnetic resonance imaging of the brain showed a large enhancing lesion in the right cerebellar hemisphere with surrounding ring lesions, suggestive of an intracranial neoplasm with metastases. However, tuberculoma of the brain was confirmed based on histology of the excision biopsy and cerebrospinal fluid (CSF) culture results: Mycobacterium tuberculosis resistant to isoniazid (INH) with sensitivity to other standard drugs, including fluoroquinolones, was cultured from CSF. No primary focus to suggest spread from elsewhere was found. The patient was treated successfully with moxifloxacin, rifampicin, pyrazinamide and ethambutol. Isolated INH-resistant intracranial tuberculoma is rare in adults. It can mimic other intracranial masses and should be kept in mind, especially in populations with a high risk of tuberculosis. Clinical use of moxifloxacin in INH-resistant tuberculomas is limited in humans and this case demonstrates that moxifloxacin may be an effective alternative treatment. |
| Databáze: | OpenAIRE |
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