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Tuesday, April 7, 2015

Tuberculoma

  • Tuberculomas are conglomerate granulomatous foci within the brain parenchyma, and is one of the many forms of central nervous system tuberculosis (extra-pulmonary tuberculosis).



UpToDate
CPG 2012
Regimen
“intensive phase”: isoniazid, rifampin, pyrazinamide, and either fluoroquinolone or IV aminoglycoside, administered daily for 2 months.
“continuation phase”: isoniazid and rifampin admininistered daily or three times a week.
With standard anti-TB regimen as shown in table below. However, ethambutol penetrates poorly into even inflamed meninges, thus should be replaced with fluoroquinolones
Duration
18 months
Minimum of 6 months



References: 
1. UpToDate. Central nervous system tuberculosis. http://www.uptodate.com/contents/central-nervous-system-tuberculosis?source=search_result&search=tuberculoma&selectedTitle=1~15#H18
2. CPG. Management of Tuberculosis. 3rd edition. Nov 2012.

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