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LETTER TO THE EDITOR
Year : 2013  |  Volume : 8  |  Issue : 1  |  Page : 85
 

Tuberculous abscess: The correct perspective


Department of Neurosurgery, Chettinad Superspeciality Hospital, Chettinad Health City, Kelambakkam, Chennai, Tamil Nadu, India

Date of Web Publication6-May-2013

Correspondence Address:
Vengalathur Ganesan Ramesh
350/4, Lloyds Road, Gopalapuram, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.111442

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How to cite this article:
Ramesh VG. Tuberculous abscess: The correct perspective. J Pediatr Neurosci 2013;8:85

How to cite this URL:
Ramesh VG. Tuberculous abscess: The correct perspective. J Pediatr Neurosci [serial online] 2013 [cited 2019 Apr 22];8:85. Available from: http://www.pediatricneurosciences.com/text.asp?2013/8/1/85/111442


Dear Sir,

I read with interest the article titled "Intramedullary tubercular abscess with syrinx formation" by Khalid et al., in the January-April, 2012 issue. [1] The authors have called caseating tuberculous granuloma as a tuberculous abscess, which is incorrect. Tuberculous abscess, by definition, is an abscess containing tubercle bacilli, with the wall showing only inflammatory cells, but no epitheloid or Langhan's giant cells, i.e. granuloma formation (Whitener, 1978). [2] This is due to a defective immune response where delayed hypersensitivity reaction is suppressed with preservation of acute inflammatory response. Hence, tuberculous abscess is distinctly different from caseating tuberculous granuloma. The incidence of tuberculous abscess itself is uncommon. [3],[4] The case reported in the above article falls into the category of caseating tuberculoma rather than a tuberculous abscess. Intramedullary tuberculoma is not uncommon, but intramedullary tuberculous abscess is extremely rare. [5] This factual error needs to be corrected.

 
   References Top

1.Khalid M, Khalid S, Mittal S, Ahmad U. Intramedullary tubercular abscess with syrinx formation. J Pediatr Neurosci 2012;7:61-3.  Back to cited text no. 1
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2.Whitener DR. Tuberculous brain abscess: Report of a case and review of the literature. Arch Neurol 1978;35:148-55.  Back to cited text no. 2
    
3.Ramamurthy B, Vasudevan MC, Thamburaj AV. Tuberculous brain abscess. Neurol India 1981;19:35-7.  Back to cited text no. 3
    
4.Ramesh VG, Sundar KS. Concomitant tuberculous and pyogenic cerbellar abscess in a patient with pulmonary tuberculosis. Neurol India 2008;56:91-2.  Back to cited text no. 4
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5.Devi BI, Chandra S, Mongia S, Chandramouli BA, Sastry KV, Shankar SK. Spinal intramedullary tuberculoma and abscess: A rare cause of paraparesis. Neurol India 2002;50:494-6.  Back to cited text no. 5
[PUBMED]  Medknow Journal  



This article has been cited by
1 Authorsę reply
Khalid, M. and Khalid, S. and Mittal, S. and Ahmad, U.
Journal of Pediatric Neurosciences. 2013; 8(1): 86
[Pubmed]



 

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