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BMJ Case Reports 2012; doi:10.1136/bcr-2012-006627
  • Reminder of important clinical lesson

Tuberculous meningitis: treat upon suspicion

  1. Adriaan G Holleboom1
  1. 1Department of Internal Medicine, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands
  2. 2Department of Neurology, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands
  3. 3Department of Infectious Diseases, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Myrthe Elisabeth Sonneveld myrthe.sonneveld{at}student.uva.nl

Summary

A 58-year-old man from Surinam was referred because of nausea, vomiting, weight loss, ascites and an altered mental state. Tuberculous meningitis was suspected upon examination of the cerebrospinal fluid and antituberculous treatment was initiated. However, the patient did not recover but developed haemiplegia with recurrent aspiration pneumonias. This case illustrates that empiric antituberculous treatment is warranted upon clinical suspicion, since no fast, sensitive diagnostic tests are available to date.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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