Introduction: Tuberculosis is a major public health problem that leads to an important cause of morbidity and mortality at worldwide level. The risk of active tuberculosis is high in solid organ recipients. When we evaluate, the clinical presentations of tuberculosis, pulmonary localizations are the most frequent type but extrapulmonary localizations are rarely seen. Among extrapulmonary sites, intracranial tuberculosis is extremely rare and only few case reports are reported in the literature.

Case Report: Here we report a case of 27 years old, male patient who received cadaveric liver transplantation due to HBV related chronic liver failure. One month after the liver transplantation, neurological symptoms were developed, following he had tonic clonic convulsion attacks. In serebral stereotactic needle biopsy of left temporal region, in addition to gliozis, rare lymphocyte infiltration, epitheloid hystiocytes and acid fast resistant bacillus had been noted. The case was diagnosed as granulomatous inflamation which was pointing out to the tuberculosis. In addition to antituberculosis therapy, patient had also been taken antiviral therapy for profilaxis. During his therapy, the reactivation of HBV was noted and the recurrent disease of HBV, viral hepatitis was diagnosed in the serial liver biopsies. Ten months after transplantation he has died because of liver failure.

Conclusions: We reported this unusual case of cerebral tuberculosis after liver transplantation in order to discuss the influence of chronic infection such as tuberculosis on the reactivation of HBV and therefore the development of the liver allograft failure due to recurrent disease.