Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Biopsy-proven Tuberculous Meningitis Mimicking CNS Sarcoidosis
Kana TojoMasahide YazakiKazuko MachidaKenji SanoKunihiro YoshidaShu-ichi Ikeda
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JOURNALS OPEN ACCESS

2007 Volume 46 Issue 24 Pages 2001-2006

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Abstract

We report a 31-year-old man with tuberculous meningitis (TM) mimicking CNS sarcoidosis. Although Mycobacterium tuberculosis (MTB) was not detected in CSF, the level of adenosine deaminase (ADA) in CSF was significantly raised. Brain biopsy showed caseous granuloma and a diagnosis of TM was made. The diagnosis of TM is often difficult and brain biopsy should be considered if MTB is not detected in the CSF. Evaluation of CSF ADA level could also strongly contribute to distinguishing TM from other meningitis. In addition to antituberculosis drugs, corticosteroid therapy was effective in our patient but careful reduction of its dosage was required.

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© 2007 by The Japanese Society of Internal Medicine
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