Zonguldak Karaelmas Üniversitesi Tıp Fakültesi, Nöroloji Anabilim Dalı, Zonguldak, Türkiye

Central nervous system tuberculosis manifests as meningitis, tuberculoma or spinal tuberculosis. Although the paradoxically development of tuberculomas during therapy is well known, the late occurance of symptomatic tuberculomas in succesfully treated tuberculous meningitis (TBM) patients has been reported very rarely. In this study we present a 28 year-old TBM patient that developed multiple intracranial and spinal tuberculomas during antituberculosis therapy and developed late intramedullary spinal tuberculoma three years after the cessation of 18 months chemotherapy. This case demonstrates the need for alert and prolonged surveillance of patients during and after central nervous system tuberculosis. As the current antituberculosis chemotherapy targets metabolically active mycobacteria and is ineffective against latent organisms, new therapeutic strategies to eliminate latency are needed for the eradication of Mycobacterium tuberculosis.