Abstract

Because of difficulty in early diagnosis and severe consequences of delay in diagnosis and treatment, tuberculosis meningitis is a serious problem for clinicians. Therefore recognizing rare cases of tuberculosis can improve clinician practice and save patients life in countries with high burden of disease. An 18-year-old girl suffered from fever, headache, illness, arthralgia, myalgia, constipation and weight loss for several weeks. In clinical exam, lethargy, Strabismus, neck stiffness, papilledema, bilateral cranial nerve VI palsy and left facial nerve palsy were observed. Pleocytosis in CSF and multiple small nodular enhancements was detected within cerebellum. The anti-tuberculosis plus corticosteroid were prescribed. Conclusion: In TB high burden regions such as Iran and Middle East, clinical diagnosis is an important tool for making decision about such cases. Though using corticosteroids in tuberculosis meningitis is still controversial, we recommend it strongly. © 2012 Science Publications.