Diagnostic Dilemma - Pediatric Oncall
Granuloma – Is it TB_?
Author: Pediatric Oncall
Question
A 15 years old boy was diagnosed to have neurocysticercosis in June 2011. CT scan showed left parietal nodular lesion with mild perilesional edema with tiny scolex. A repeat MRI scan in July 2011 showed multiple confluent granulomas in left parietal region with considerable perilesional edema suggestive of tuberculomas. ESR was 110mm at end of 1 hour. He was only on carbamazepine for the focal convulsion. TB treatment had not been started. He presented after 4 months for further management.
Answer Discussion :
S
shanthi shanthi
Rule out HIV. Additional tests for Tuberculosis and CSF and serological tests for neurocysticercosis. MRI can help.
23 hours ago
M
mahammad aezeldein
start tb treatment
1 Day ago
L
ladumor mahesh
give prednisolone for 1week.. then albendazol for 21days
3 Days ago
A
afua osew gyamfi
additional history and physical examination shoild be done again and compare with previous findings to see if child is doing better.
do HIV test to rule out immunosuppression
do mantoux test, sputum for AFBs and gene xpert to confirm TB
do chest xray to see if it is suggestive for pulmonary TB as well
repeat ESR to see if it is rising.
a repeat head CT scan should also be repeated.

9 Days ago
G
Gayan Kodi
start TB treatment
10 Days ago
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