Cerebral tuberculosis in patients with the acquired immunodeficiency syndrome (AIDS). Report of 6 cases and review

Medicine (Baltimore). 1997 Nov;76(6):423-31. doi: 10.1097/00005792-199711000-00005.


Cerebral tuberculosis (TB) was diagnosed in 6 (4%) of 156 HIV-infected patients with TB seen at our institution over 6 years. We describe here the clinical and radiologic features of these cases and of 15 others reported in the literature. Of the 21 patients, 59% were intravenous drug users. Presenting symptoms were fever (76%), confusion (52%), seizures (38%), and headache (38%). Fourteen patients (66%) had previous or active extracerebral TB at presentation. Cranial CT scan showed ring-(62%) or nodular-(24%) enhancing lesions or mixed forms (14%). Among the 12 patients who underwent a brain biopsy, bacteriologic evidence of TB was found in 9. Four patients (19%) died during hospitalization. Among the 17 others who received antituberculous therapy, only 1 developed neurologic sequelae. Five patients also received steroid therapy to control cerebral edema or paradoxical growth of the cerebral mass lesions. TB should be considered as a cause of cerebral mass lesions in HIV-infected patients, especially if tuberculous infection is suspected at other sites.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acquired Immunodeficiency Syndrome / complications*
  • Adult
  • Antitubercular Agents / therapeutic use
  • Brain Diseases / diagnosis
  • Brain Diseases / drug therapy
  • Brain Diseases / microbiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Photomicrography
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Tuberculosis / complications*
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy
  • Tuberculosis / microbiology


  • Antitubercular Agents