Adjuvant interferon-γ treatment in two cases of refractory tuberculosis of the brain

Tuberculosis (TB) of the brain is often refractory and has the highest morbidity and mortality among the mycobacterial infections. A recent report suggests that interferon-gamma may be of help since it can modulate the host inflammatory response against mycobacteria in the brain. Here, we report on a 44-year-old woman with multiple tuberculomas in the brainstem and a 40-year-old man with two large TB abscesses in the brain, both of whom had no response to anti-TB medications for 5 and 7 months, respectively, but with near-complete resolution with adjuvant interferon-gamma therapy (50 mu g/m(2), subcutaneously, three times per week). Our cases show that refractory brain TB in immunocompetent patients can be successfully treated with adjuvant interferon-gamma therapy, without any significant side effects. (C) 2011 Elsevier B.V. All rights reserved.