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Tuberculosis
Miral D. Jhaveri, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Tuberculosis (TB)
              • Definitions

                • Infection by acid-fast bacillus Mycobacterium tuberculosis
                • CNS TB almost always secondary to hematogenous spread (often pulmonary)
                  • Manifestations include tuberculous meningitis (TBM)
                  • Localized parenchymal infection: Tuberculoma (common), TB abscess (rare)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Angiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Soni N et al: Cerebrovascular complications in tuberculous meningitis-a magnetic resonance imaging study in 90 patients from a tertiary care hospital. Neuroradiol J. 33(1):3-16, 2020
                                            2. Azeemuddin M et al: Neuroimaging findings in tuberculosis: a single-center experience in 559 cases. J Neuroimaging. 29(5):657-68, 2019
                                            3. Schaller MA et al: Central nervous system tuberculosis: etiology, clinical manifestations and neuroradiological features. Clin Neuroradiol. 29(1):3-18, 2018
                                            4. Zunt JR: Tuberculosis of the central nervous system. Continuum (Minneap Minn). 24(5, Neuroinfectious Disease):1422-38, 2018
                                            5. Chaudhary V et al: Central nervous system tuberculosis: an imaging perspective. Can Assoc Radiol J. 68(2):161-70, 2017
                                            6. Leonard JM: Central nervous system tuberculosis. Microbiol Spectr. 5(2), 2017
                                            7. Chamie G et al: HIV-associated central nervous system tuberculosis. Semin Neurol. 34(1):103-15, 2014
                                            8. Garcia-Monco JC: Tuberculosis. Handb Clin Neurol. 121:1485-99, 2014
                                            9. Guleria R et al: Central nervous system tuberculosis. Indian J Tuberc. 61(3):195-9, 2014
                                            10. Torres C et al: Central nervous system tuberculosis. Top Magn Reson Imaging. 23(3):173-89, 2014
                                            11. Wasay M et al: Cerebral infarction and tuberculoma in central nervous system tuberculosis: frequency and prognostic implications. J Neurol Neurosurg Psychiatry. 85(11):1260-4, 2014
                                            12. DeLance AR et al: Tuberculoma of the central nervous system. J Clin Neurosci. 20(10):1333-41, 2013
                                            13. Chin JH et al: Central nervous system tuberculosis: challenges and advances in diagnosis and treatment. Curr Infect Dis Rep. ePub, 2013
                                            14. Maclean KA et al: Extrapulmonary tuberculosis: imaging features beyond the chest. Can Assoc Radiol J. 64(4):319-24, 2013
                                            15. Ramzan A et al: Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatr Neurol. 48(1):30-5, 2013
                                            16. Sáenz B et al: The dual face of central nervous system tuberculosis: a new Janus Bifrons? Tuberculosis (Edinb). 93(2):130-5, 2013
                                            17. Thwaites GE: Advances in the diagnosis and treatment of tuberculous meningitis. Curr Opin Neurol. 26(3):295-300, 2013
                                            18. Thwaites GE et al: Tuberculous meningitis: more questions, still too few answers. Lancet Neurol. 12(10):999-1010, 2013
                                            19. Patkar D et al: Central nervous system tuberculosis: pathophysiology and imaging findings. Neuroimaging Clin N Am. 22(4):677-705, 2012
                                            20. Wu XR et al: Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 130(6):e1433-40, 2012
                                            21. Be NA et al: Pathogenesis of central nervous system tuberculosis. Curr Mol Med. 9(2):94-9, 2009
                                            22. Peng J et al: Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur J Radiol. 81(12):4057-63, 2012
                                            23. Mohan S et al: Lipid resonance on in vivo proton MR spectroscopy: value of other metabolites in differential diagnosis. Neuroradiol J. 23(3):269-78, 2010
                                            24. Gupta RK et al: Central nervous system tuberculosis. Neuroimaging Clin N Am. 2011 Nov;21(4):795-814, vii-viii. Epub 2011 Sep 23. Review. Am. 21(4):795-814, vii-viii, 2011
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Tuberculosis (TB)
                                                        • Definitions

                                                          • Infection by acid-fast bacillus Mycobacterium tuberculosis
                                                          • CNS TB almost always secondary to hematogenous spread (often pulmonary)
                                                            • Manifestations include tuberculous meningitis (TBM)
                                                            • Localized parenchymal infection: Tuberculoma (common), TB abscess (rare)

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Angiographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Soni N et al: Cerebrovascular complications in tuberculous meningitis-a magnetic resonance imaging study in 90 patients from a tertiary care hospital. Neuroradiol J. 33(1):3-16, 2020
                                                                                      2. Azeemuddin M et al: Neuroimaging findings in tuberculosis: a single-center experience in 559 cases. J Neuroimaging. 29(5):657-68, 2019
                                                                                      3. Schaller MA et al: Central nervous system tuberculosis: etiology, clinical manifestations and neuroradiological features. Clin Neuroradiol. 29(1):3-18, 2018
                                                                                      4. Zunt JR: Tuberculosis of the central nervous system. Continuum (Minneap Minn). 24(5, Neuroinfectious Disease):1422-38, 2018
                                                                                      5. Chaudhary V et al: Central nervous system tuberculosis: an imaging perspective. Can Assoc Radiol J. 68(2):161-70, 2017
                                                                                      6. Leonard JM: Central nervous system tuberculosis. Microbiol Spectr. 5(2), 2017
                                                                                      7. Chamie G et al: HIV-associated central nervous system tuberculosis. Semin Neurol. 34(1):103-15, 2014
                                                                                      8. Garcia-Monco JC: Tuberculosis. Handb Clin Neurol. 121:1485-99, 2014
                                                                                      9. Guleria R et al: Central nervous system tuberculosis. Indian J Tuberc. 61(3):195-9, 2014
                                                                                      10. Torres C et al: Central nervous system tuberculosis. Top Magn Reson Imaging. 23(3):173-89, 2014
                                                                                      11. Wasay M et al: Cerebral infarction and tuberculoma in central nervous system tuberculosis: frequency and prognostic implications. J Neurol Neurosurg Psychiatry. 85(11):1260-4, 2014
                                                                                      12. DeLance AR et al: Tuberculoma of the central nervous system. J Clin Neurosci. 20(10):1333-41, 2013
                                                                                      13. Chin JH et al: Central nervous system tuberculosis: challenges and advances in diagnosis and treatment. Curr Infect Dis Rep. ePub, 2013
                                                                                      14. Maclean KA et al: Extrapulmonary tuberculosis: imaging features beyond the chest. Can Assoc Radiol J. 64(4):319-24, 2013
                                                                                      15. Ramzan A et al: Childhood tubercular meningitis: an institutional experience and analysis of predictors of outcome. Pediatr Neurol. 48(1):30-5, 2013
                                                                                      16. Sáenz B et al: The dual face of central nervous system tuberculosis: a new Janus Bifrons? Tuberculosis (Edinb). 93(2):130-5, 2013
                                                                                      17. Thwaites GE: Advances in the diagnosis and treatment of tuberculous meningitis. Curr Opin Neurol. 26(3):295-300, 2013
                                                                                      18. Thwaites GE et al: Tuberculous meningitis: more questions, still too few answers. Lancet Neurol. 12(10):999-1010, 2013
                                                                                      19. Patkar D et al: Central nervous system tuberculosis: pathophysiology and imaging findings. Neuroimaging Clin N Am. 22(4):677-705, 2012
                                                                                      20. Wu XR et al: Pediatric tuberculosis at Beijing Children's Hospital: 2002-2010. Pediatrics. 130(6):e1433-40, 2012
                                                                                      21. Be NA et al: Pathogenesis of central nervous system tuberculosis. Curr Mol Med. 9(2):94-9, 2009
                                                                                      22. Peng J et al: Differentiation of intracranial tuberculomas and high grade gliomas using proton MR spectroscopy and diffusion MR imaging. Eur J Radiol. 81(12):4057-63, 2012
                                                                                      23. Mohan S et al: Lipid resonance on in vivo proton MR spectroscopy: value of other metabolites in differential diagnosis. Neuroradiol J. 23(3):269-78, 2010
                                                                                      24. Gupta RK et al: Central nervous system tuberculosis. Neuroimaging Clin N Am. 2011 Nov;21(4):795-814, vii-viii. Epub 2011 Sep 23. Review. Am. 21(4):795-814, vii-viii, 2011