Tuberculous meningitis diagnosed on repeat cerebrospinal fluid analysis after unremarkable initial findings: a case report.
- 1Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea.
- 2Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea. [email protected].
Abstract
Tuberculous meningitis (TBM) is a severe and often fatal form of extrapulmonary tuberculosis. We describe a case in which the initial cerebrospinal fluid (CSF) analysis showed no specific abnormalities, but a diagnosis was established after repeat CSF evaluation. A 41-year-old female presented with a 10-day history of persistent fever and headache. Initial CSF analysis demonstrated an opening pressure of 150 mmH2O, a white blood cell (WBC) count of 10/μL, a glucose level of 50 mg/dL, and a protein level of 31.4 mg/dL. Despite treatment with an antiviral agent and doxycycline, her symptoms did not improve. A repeat CSF analysis demonstrated an opening pressure of 120 mmH2O, an elevated WBC count of 140/μL (55% lymphocytes), a glucose level of 52 mg/dL, and an elevated protein level of 201.6 mg/dL, which was highly suggestive of TBM. This case highlights the importance of repeat CSF analysis based on clinical judgment when diagnosing TBM.
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BibTeX
@article{na2026tuberculous,
title = {{Tuberculous meningitis diagnosed on repeat cerebrospinal fluid analysis after unremarkable initial findings: a case report.}},
author = {Yoonjeong Na and Jung-Ju Lee and Byung-Kun Kim and Namoh Kim and Michelle Sojung Youn},
journal = {Encephalitis (Seoul, Korea)},
year = {2026},
month = aug,
doi = {10.47936/encephalitis.2026.00115},
url = {https://europepmc.org/article/MED/42843900},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Tuberculous meningitis diagnosed on repeat cerebrospinal fluid analysis after unremarkable initial findings: a case report.
AU - Yoonjeong Na
AU - Jung-Ju Lee
AU - Byung-Kun Kim
AU - Namoh Kim
AU - Michelle Sojung Youn
PY - 2026
DA - 2026/08/11
JO - Encephalitis (Seoul, Korea)
DO - 10.47936/encephalitis.2026.00115
UR - https://europepmc.org/article/MED/42843900
AB - Tuberculous meningitis (TBM) is a severe and often fatal form of extrapulmonary tuberculosis. We describe a case in which the initial cerebrospinal fluid (CSF) analysis showed no specific abnormalities, but a diagnosis was established after repeat CSF evaluation. A 41-year-old female presented with a 10-day history of persistent fever and headache. Initial CSF analysis demonstrated an opening pressure of 150 mmH2O, a white blood cell (WBC) count of 10/μL, a glucose level of 50 mg/dL, and a protein level of 31.4 mg/dL. Despite treatment with an antiviral agent and doxycycline, her symptoms did not improve. A repeat CSF analysis demonstrated an opening pressure of 120 mmH2O, an elevated WBC count of 140/μL (55% lymphocytes), a glucose level of 52 mg/dL, and an elevated protein level of 201.6 mg/dL, which was highly suggestive of TBM. This case highlights the importance of repeat CSF analysis based on clinical judgment when diagnosing TBM.
SN - 2765-4559
SN - 2734-1461
ER -