Cervical intramedullary tuberculoma and tuberculous kyphosis in a 23-month-old child: case report.

ous pathogen in many parts of the world being increasingly responsible for disease. Worldwide 7–10 million people have tuberculosis; in 1995 in the United States 22 201 new cases were reported. Neurotuberculosis accounts for about 5% of extrapulmonary cases of tuberculosis. It is a result of the bacteremic stage of the disease, during which tuberculous lesions (Rich’s foci) may form in the meninges or within the substance of the brain or spinal cord, or both. Months or years later, these foci may rupture into the cerebrospinal fluid, causing meningitis, or expand into a tuberculoma within the parenchyma of the brain or spinal cord, causing focal neurologic signs. The most common manifestations of tuberculosis in the central nervous system are tuberculous meningitis and intracranial tuberculoma. Tuberculous meningitis is more common than intracranial tuberculoma, more frequent in children than adults and is often found in patients of low socioeconomic status. The majority of spinal cord disease, however, is secondary to tuberculous spondylitis (Pott’s disease), causing vertebral body destruction and spinal cord compression, and accounting for 50%–60% of osseous tuberculosis. The usual sites of involvement are the thoracolumbar and lower thoracic spine, with infection seeding the metaphysis of a single vertebral body, spreading under the anterior longitudinal ligament and causing osseous destruction or abscess formation. Ensuing osseous destruction may lead to anterior vertebral collapse and kyphosis. Intramedullary tuberculoma of the spine is a rare manifestation of disseminated hematogenous tuberculosis. Approximately 180 cases of intramedullary tuberculoma have been reported in the world literature, with most recent case reports from developing countries and HIV-positive populations. We report a case of intramedullary tuberculoma in a young child. Signed informed consent was obtained. The child’s chart and imaging studies were reviewed.