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A 23 year-old woman presented with progressive loss of sensation on the left associated with intermittent focal twitching of the left side. She had a remote history of a positive PPD treated with six months of INH.
Coronal T1-weighted MRI scans with gadolinium. Note the numerous ring enhancing lesions in the right parietal lobe with surrounding edema and mass effect on the lateral ventricle. Brain biopsy showed granulomatous inflammation. AFB and fungal stains were negative. After 8 weeks, cultures were positive for mycobacterium tuberculosis.
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