Tubercular brain abscess mimicking as Pyogenic abscess in a 9 year old immunocompetent vaccinated female child:- A case report

Central Nervous System Tuberculosis may present as commonly encountered Tuberculous Meningitis or Tuberculous mass lesions (Tuberculoma) and rarely as Tubercular brain abscess[1].Patient should be looked for primary pulmonary tuberculosis or any other body organ involvement [2]. Differentiating Tubercular abscess from pyogenic brain abscess is a diagnostic challenge. The authors here in present a case of tubercular brain abscess in a 9 year old female with short history and rapid progression of neurological deficit. Neuroimaging revealed brain abscess but diagnosis was confirmed later on neurosurgical intervention and identification of AFB in pus. Clinically one cannot differentiate Pyogenic brain abscess from Tubercular brain abscess. Moreover, Tuberculous brain abscess can manifest acutely with sudden deterioration of neurological function .We stress on staining of pus for acid fast bacillus even pus should be sent for PCR for tubercular bacilli.