Tubercular Meningitis Presenting as Section Multiple Cranial Nerve Palsy

Abstract

Tubercular Meningitis (TBM) is caused due to the seeding of meninges with mycobacterium tuberculosis and about one-third of the world’s population is infected with it. The risk of contracting the infectionincreases in immunocompromised states which includes diabetes mellitus, chronic use of steroids, chronic alcoholism and Human Immunodeficiency Virus (HIV) co-infection. Here, a case of 47-year-old female has been presented, who reported to the Department of Medicine with complaints of weakness overthe leftside of the face associated with diminished hearing and tinnitus in the left ear and subjective vertigo since 20 days. Initially, all the above involvement was attributed to bell’s palsy but no improvement was seen with its treatment. Incidentally, she was found to be HIV positive and lumbar puncture was done and eventually, she was diagnosed as a case of TBM. The patient was successfully treated with antitubercular medications and supportive measures and she responded well. She was discharged with antitubercular medications with regular follow-up in view of starting antiretroviral therapy after 6 weeks.