An unusual case of temporal lobe tuberculoma with co-existing fungal infection in a diabetic
patient is reported. A 54-year-old male with uncontrolled Diabetes mellitus was treated with
anti-tuberculosis drugs for six months for temporal lobe tuberculoma. Follow-up scans showed
increase in the size of the lesion in-spite of good drug compliance. After complete excision of
the lesion, the pus encountered was sent for microbiological investigations, which showed
acid-fast bacilli and multi-polar budding yeast cells. So, the patient was treated with antituberculosis
drugs and Itraconazole. Follow-up scans after six months showed good resolution.
In conclusion, any tuberculoma, which does not respond to medical management alone, should
be surgically excised and evaluated for any other co-existing infection.