Expansive brain lesion in a patient with AIDS

Authors

  • Gabriela Queiroz Fontes Instituto de Infectologia Emílio Ribas - São Paulo - SP - Brasil
  • José Ernesto Vidal Instituto de Infectologia Emílio Ribas - São Paulo - SP - Brasil

DOI:

https://doi.org/10.5935/2764-734X.e20250255

Keywords:

AIDS-Related Opportunistic Infections, Tuberculoma, Intracranial, Toxoplasmosis, cerebral, Case report

Abstract

A cerebral tuberculoma is a potential complication of disseminated tuberculosis in people living with HIV/AIDS, especially in developing countries. We report the case of a 52-year-old woman with advanced HIV disease and confirmed pulmonary tuberculosis, who presented with mental confusion, syncope, and a multilobulated intracranial tumor. She exhibited clinical and radiological worsening after 3 months of treatment (already in the maintenance phase), which resulted in therapeutic doubts: cerebral toxoplasmosis was the main differential diagnosis and empirical treatment was initiated. We also decided to reinitiate the complete tuberculosis regimen and add corticosteroids to it. Examination of a second sample of cerebrospinal fluid showed acid-fast bacilli; however, a stereotactic biopsy did not show any etiologic agent. After a prolonged hospital stay of 2 months, the patient was discharged to an outpatient clinic where she followed up for almost 2 years presenting evident clinical improvement, but with only partial improvement in terms of neuroimaging.

References

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Published

2025-04-30

How to Cite

Fontes, G. Q., & Vidal, J. E. (2025). Expansive brain lesion in a patient with AIDS. Infections in Evidence, 4, e20250255. https://doi.org/10.5935/2764-734X.e20250255

Issue

Vol. 4 (2025)

Section

Case Reports

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