Tuberculous brain abscess--a diagnostic and therapeutic challenge.

Central nervous system tuberculosis may present as commonly encountered tuberculous meningitis or tuberculous mass lesions [common tuberculoma, and rare tuberculous brain abscess (TB-Abs)]. TB-Abs was first described by Evans and Rand (early 1930s), and is still very rare in world literature. This rare case report serves as a reminder for tuberculosis as etiology of brain abscess in a HIV-negative patient, who recovered completely after neurosurgical intervention. A 15 years boy, without childhood vaccination, presented with weeklong history of high fever, headache, vomiting, generalized convulsions and double vision on looking towards left. There was no previous history of convulsive disorder, head trauma or history suggestive of any infective focus anywhere. He was febrile, irritable, disoriented with signs of meningeal irritation; and had left sixth cranial nerve palsy, left-sided hemiparesis with absent papilloedema – suggestive of meningitis with raised intracranial tension. Other systems were noncontributory.