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Tuberculosis (TB) is still a problem in Paediatrics practice. Diagnosis of extra-pulmonary tuberculosis in children has remained difficult despite the gains made by newer TB diagnostic investigations. We report a twelve-year-old female, with a history of neck pain, fever, headache and weakness of all the limbs. The results of TB diagnostic investigations were all negative and the child was treated for meningitis with no clinical response. However, she responded only to a therapeutic trial of anti-TB drugs with improvement of motor function of all the limbs. The child had completed 12 months anti-TB chemotherapy for extra-pulmonary tuberculosis with full recovery of all the neurological deficits. Currently she is on follow up. A high index of suspicion is needed for diagnosis and care of rare/emerging extra-pulmonary tuberculosis in childhood.

Introduction: Intracranial abscesses are usually life-threatening. Minimally invasive procedures are effective especially if deep seated, located in dominant or eloquent cortex. Image guidance especially, ultrasound guidance, could suffice in resource poor setting. Absence of appropriate probes, dedicated theatre ultrasonographic setup, and technical know-how may be a drawback. We present our experience with four cases managed recently in our institution. Highlighting our limitation and efforts made to overcome this. Case Series: Four consecutives cases, a 2-month-old baby, a 15-year-old female, a 67-year-old man, and a 2-month-old baby with a right deep frontoparietal, occipital, right fronto-parieto-occipital, and frontoparietal intracranial abscesses respectively, had ultrasound-guided aspiration of lesion using adapted transducer, together with good collaboration with the radiology department of the hospital. Procedure was successful. Conclusion: Ultrasound guidance in resource poor setting remains a good option with due inter-disciplinary collaboration.