Cerebral tuberculous abscess is exceptional. We report on the case of
a H.I.V. positive 29 year-old man suffering from high intracranial pre
ssure together with a cerebellar syndrome. The CT scan revealed a volu
minous abscess of the left cerebellar hemisphere. Anatomical and patho
logical examination of the extracted mass showed a tuberculous abscess
. 16 months after surgery and antituberculous treatment, the patient's
symptoms have disappeared and he has resumed his professional activit
ies. Though controversial, a pathogenic continuum between a tuberculom
a and a tuberculous abscess may be assumed to exist. The A.I.D.S. pand
emia reactivates the tuberculous foci, increases the risks of contagio
n reduced the effectiveness of treatment, and justifies a systematic s
earch for the bacillus of Koch, after puncture, in any cerebral absces
s.