Central Nervous System Tuberculosis Presenting With Multiple Ring-Enhancing Lesions: A Diagnostic Challenge.

Mycobacterium tuberculosis (TB) used to be one of the most widespread infections around the world. However, with improvements in sanitation, access to therapy, and increased public health efforts, TB has almost been eliminated from the developed world. While classically located in the lungs, infection can spread to distant sites from either late stage complications or as a sequelae from immunosuppression. In this paper, we present a case of a 53-year-old female who presented with nonspecific neurological complaints and multiple ring-enhancing lesions in the brain who was eventually diagnosed with central nervous system (CNS) tuberculosis after a lengthy workup despite following guideline-directed management. The purpose of this case report is to review an approach for ring-enhancing lesions and clinical considerations for central nervous system tuberculosis and add to the limited body of literature on the subject.