Mycobacterium tuberculosis and atypical tubercle bacilli Mycobacterium avium intracellular infection have been described as uncommon CNS manifestations of AIDS. The clinical spectrum of CNS tuberculosis with HIV infection includes meningitis, cerebral abscesses and tuberculomas. CNS involvement occurs in 10-20% patients with AIDS-related tuberculosis, and in these patients mortality is high. HIV-infected intravenous drug abusers are, in particular, at high risk of developing focal CNS tuberculosis. Clinical features, including imaging characteristics, are similar to those seen in patients without HIV infection. In patients with M avium intracellulare infection, single or multiple mass lesions appear to be more than twice as common as meningitis. Every effort should be made to establish the correct diagnosis as most types of CNS tuberculosis in HIV-infected patients are responsive to treatment. In contrast to the rapid advances in the management of pulmonary tuberculosis, there have been only a few clinical studies in patients with CNS tuberculosis, including tuberculous meningitis.
Last date updated on July, 2014