Tuberculous meningitis diagnosed on repeat cerebrospinal fluid analysis after unremarkable initial findings: a case report.

Authors

Yoonjeong Na, Jung-Ju Lee, Byung-Kun Kim, Namoh Kim, Michelle Sojung Youn

Published in

Encephalitis (Seoul, Korea). Volume 6. Issue 4. Pages 109-112. Epub Aug 11, 2026.

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.

PMID:
42843900
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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