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-γ 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-γ therapy (50 μg/m(2), subcutaneously, three times per week). Our cases show that refractory brain TB in immunocompetent patients can be successfully treated with adjuvant interferon-γ therapy, without any significant side effects.
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