CNS TUBERCULOMA

[dkvini]

Sir,
    My wife is suffering from CNS TUBERCULOMA. ATT treatment has been started.MRI  has reported 20x15x21mm size tissue in the left perintal lobe.Repeat MRI after one month has shown considerable reduction in EDEMA and about 10% reduction in tissue/clot.
My question are
a) Can we consider reduction in size of tissue in brain as positive sign and we can say that treatment/Dignosis is on right path.
b)whether need for surgery does not arise due to reduction in size?
c)whether this deises is 100% curable?

[caregiver222]

With due respects TB is not "100% curable".  At best you can hope for remission.

Secondly there are various types, including MDR tb and XTRB. This stands for multidrug resistant and extra-multi-drug resistant. TB has been the scourge of mankind for a thousand years.

Often there as many as four drugs prescribed and they must be taken for long periods of time without missing a dose. For an evaluation of the drugs and the United States protocols look up Pubmed, the United States government database.

Although commonly thought of as a lung disease the TB bacteria can grow anywhere in the body and encapsulate themselves. It is not appropriate to state on an internet board "the need for surgery does not arise". This is a judgemental call.

Reduction in size is certainly a positive sign, but these organisms are very hearty and difficult to eradicate.

[clearnephro]

dear dkvini , i consider the reduction in the size of the lesion as a good sign , it may require full 6 month or longer therapy for lesion to reduce significantly , although you have not mentioned the biopsy report of the tumour , theraputic trial does sometimes consolidate the diagnosis in pt living in high prevalent zones for TB such as india , pakistan and african countries . tuberculoma is a pathology which needs surgery only in few exceptional circumstances . most of the time it is amenable to medical management . hence need for surgery does not arise as you have started ATT just one month before . this disease is 100% curable , and the only residuum could be convulsion and seizure seizures even after bacteriological cure due to scar . hence one may have to take anticonvulsants for long periods even after regression of the lesion .