Volume 26, Issue 129, November 2022

Double pathology in cases of cold abscess neck: A case report

Rajasekar MK, Sarenya KS^♦

Department of ENT, Sree Balaji Medical College and Hospital, India

^♦Corresponding author
Department of ENT, Sree Balaji Medical College and Hospital, India

ABSTRACT

In 2022, a 20-year-old male patient came to our OPD with a complaint of slight neck pain and swelling in the anterior side of his neck for two months. On observation, the swelling was present in the anterior aspect of the neck in the midline above the suprasternal notch. USG in the neck shows a heterogeneous lesion with moving echogenic debris in the anterior aspect of the neck MRI showed a well defined T1 isointense T2 hypointense peripherally enhancing lesion showing no diffusion restriction/blooming in the right cerebellum. While CBNAAT detected the presence of mycobacterium tuberculosis, high dose contrast enhanced computed tomography shows ill defined hypointense peripheral enhancing collection in the right anterior aspect of the neck with multiple peripherals enhancing necrotic lymph nodes. Tissue culture shows no growth. The pathology report revealed the presence of persistent necrotizing granulomatous inflammation with tuberculosis neck with MRI brain showing cerebral tuberculoma. A thorough assessment and prompt treatment are necessary to avoid a fatal prognosis because cerebral tuberculoma might manifest with very minimal neurological symptoms while having massive lesions.

Keywords: Tuberculosis, Cerebellar tuberculoma, Antituberculosis therapy

Medical Science, 2022, 26, ms488e2410

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DOI: https://doi.org/10.54905/disssi/v26i129/ms488e2410

Published: 23 November 2022