Cerebral tuberculoma 11 years after renal transplantation

A case of cerebral tuberculoma in a 39-year-old patient who had received a renal graft from a living related donor 11 years previously is reported. Th e patient had a major seizure, progressive psychiatric signs and fever 5 da ys prior to admission. The clinical history suggested a neurological cause and rapid diagnosis of a cerebral tuberculoma was made by a computed tomogr aphy-guided stereotactic puncture of a space-occupying cerebral lesion. The aspirated pus contained Mycobacterium tuberculosis. Anti-tuberculous thera py with isoniacid, rifampicin, ethambutol and pyracinamide was administered , Transplant function deteriorated and the patient died due to intractable septicemia with multiorgan failure from pulmonary infection dissemination a nd additional urinary tract infection with atypical mycobacteria. The chanc e for a benign clinical course necessitates vigorous procedures for an earl y diagnosis of cerebral infections in renal transplant recipients with neur ological/psychiatric signs.