Disseminated tuberculosis with multiple intracerebral tuberculomas in a patient with anorexia nervosa

Objective: Multiple tuberculous mycobacterial infections infrequently occur in immunocompromised patients. The malnutrition resulted from anorexia nervosa may contribute to the significant impairment of immunity. The authors present a 23-year-old female patient initially diagnosed with anorexia nervosa. Method: Immunological study revealed that helper T-cell (CD4) and cytotoxic T-cell (CD8) comprised 25 and 32%, respectively, with a CD4 to CD8 ratio of 0.78. Brain magnetic resonance imaging revealed various multiple rings enhancing lesions with edematous change in both cerebral and cerebellar hemispheres. Results: Open biopsy disclosed palisading epithelioid granuloma surrounded by inflamed granulation tissue. After antituberculous therapy for 12 months, her weight was completely restored, but multiple intracranial tuberculomas were not completely disappeared. Conclusion: Disseminated tuberculous mycobacterial infections including multiple intracranial tuberculomas may be attributed to immunocompromised status in anorexia nervosa. (c) 2007 by Wiley Periodicals, Inc.