속립성 결핵은 개체의 면역이상으로 결핵균이 전신의 장기에 파종될 시 나타난다. 최근에는 뇌조직도 흔히 침범되는 장기의 하나로 인식되고 있으며 뇌조직에서도 다발성 병변을 보이는 것이 일반적이다. 저자들은 두통과 미열을 주소로 입원한 8세 남아에서 방사선학적 소견과 위액 흡입에 의한 배양 결과로 확진된 속립성 결핵과 두개내 다발성 결핵종을 경험하여 문헌 고찰과 함께 보고하였다. 속립성 결핵이 의심되는 경우에 신경학적 증상의 유무에 관계없이 중추신경계의 영상 검사가 필요하다.
Although the incidence of tuberculosis has been decreased, it is still an important community acquired infectious disease in the world. Miliary or disseminated tuberculosis occurs from the inadequacy of host defense in controling tuberculous infection. Generally, brain parenchyme has been considered to be a rare involving organ than other organs or meninges in miliary tuberculosis. However it has been proving that the brain parenchyme is commonly involved organ in miliary tuberculosis even without neurological manifestations. We report a case of 8 yr-old male patient, who was diagnosed as having an miliary tuberculosis with multiple tuberculoma throughout the brain. The tuberculous lesions of lung and brain were nearly cleared within 3 months with anti-tuberculous therapy. With a reveiw of related literatures, we suggest that the patients with miliary tuberculosis should be evaluateded about brain involvement.
