A case of multiple intracranial tuberculous nodule following miliary tuberculosis wasreported. The case was a 19-year-old woman visited a general practitioner, bacause offever. Chest x-ray film on the first visit showed diffuse granular shadows in her both lungswith pleural effusion in the left side. The case was diagnosed as bacterial pneumonia, andwas treated with antibiotics. She had been getting worse, and the doctor finally examinedher sputum, and tubercle bacilli were seen in her sputum (Gaffky 4) by the Ziehl Neelsen'sstaining. She was introduced to our hospital. Chest x-ray film on admission showed diffusegranular shadows in her both lungs and she was diagnosed her as miliary tuberculosis, andanti-tuberculous therapy was quickly started. She didn't complain of any neurologicaldisorders, but her brain CT showed several nodules in the left cerebral cortex enhanced withcontrast medium. Ti weighted MRI enhanced by Gd-DTPA revealed abnormal enhancements in the cerebrum, the cerebellum, and the midbrain. She was treated with antiepilepticdrugs, but after 65 days, she started to suffer from epileptic stroke. Six monthslater, her brain leisions have improved by the use of anti-tuberculosis drugs and antiepipleticdrugs. The incidence of tuberculosis has decreased in Japan, and, many doctors didnot show concern on, thus, a doctor's delay is a serious problem in Japan. Advocary showedbe made to doctors to detect tuberculous patients as early as possible.
