Cerebral granulomas: differentiating between tuberculosis and cysticercosis

Hemingway, Cheryl

Cerebral granulomas: differentiating between tuberculosis and cysticercosis

Thesis / Dissertation

1999

Publisher

University of Cape Town

Department

Department of Paediatrics and Child Health

Faculty

Faculty of Health Sciences

Abstract

The study attempted to determine the optimal feasible method to differentiate the intracranial single granuloma caused by tuberculosis from that caused by cysticercosis. 62 patients who were found to have a single granuloma on computerised tomography (CT) scanning • answered a questionnaire • were examined • underwent further special investigations looking for evidence of either tuberculosis or cysticercosis. The 47 mantoux negative patients in whom a diagnosis of tuberculosis was unlikely were treated with the anti-helminthic albendazole. The remaining 15 patients, all of whom had a positive mantoux skin test, received six months of anti-tuberculosis chemotherapy. At follow-up at 3 months only 8% of children had had further seizures and the CT scan revealed that in 96% of children the lesions had disappeared or calcified. This increased to 98% at 6-month follow-up. Calcification occurred only in those diagnosed as neurocysticercosis. Analysis of special investigations performed showed that no single investigation taken in isolation is able definitively to differentiate the single granuloma caused by neurocysticercosis from that caused by tuberculosis.

Keywords

tuberculosis

cysticercosis

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