A 16-year-old boy with a lesion of the left frontal lobe

A 16-year-old boy from Bombay, India had suffered repeated seizures and was admitted to the hospital. A computed tomographic (CT) scan showed swelling and a mass in the left frontal region of the brain. The three most common conditions which could cause lesions in the brain of a child from India are tumor, tuberculoma (a tumor-like mass in the brain caused by Mycobacterium tuberculosis, which causes tuberculosis), and cysticercosis (caused by tape worms). The clinical features did not indicate diagnosis of a cerebral glioma, a type of tumor which occurs in children and causes seizures. It was thought that the mass was a tuberculoma as tuberculosis is endemic in Bombay and the clinical features were compatible with the diagnosis of tuberculoma without manifestations outside the brain. The patient had been vaccinated against tuberculosis in childhood, but vaccination is not an assurance that the disease will not develop later in life. However, the patient was given drugs for the treatment of tuberculosis and still had the seizures. Cysticercosis was still a possible diagnosis. Abscesses caused by infectious agents such as bacteria, fungi and protozoa, or parasites were also considered. A brain biopsy was performed and examination of the tissue revealed that the patient had cysticercosis, which was manifested as a granulomatous abscess in the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)