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Tuberculosis - CNS and chest

Case contributed by Ayman Elmesalamy
Diagnosis probable

Presentation

The patient presented with sudden onset mild right sided weakness

Patient Data

Age: 45
Gender: Male
mri

The diffusion-weighted images show left deep parietal periventricular light bulb signal which is likely related to the clinical right sided mild weakness. The FLAIR and T2 images show small areas of abnormal signal at the brainstem and left parietal region. MR post-contrast series shows multiple tiny enhancing focal areas within the cerebellum, brainstem and both cerebral hemispheres

x-ray

Bilateral miliary nodules.  

Case Discussion

The chest x-ray and laboratory findings strongly suggest the possibility of miliary tuberculosis with CNS tuberculosis.

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