Central nervous system tuberculosis, one of the most challenging of infections

ABSTRACTWe are presented a 35-year-old patient with no previous relevant medical history who was admitted to
the emergency department for fever, altered mental status and diffuse abdominal pain. Initial evaluation failed to
demonstrate the presence of thoracic or abdominal deep infection. The clinical course was marked by a deterioration of
the neurological condition. The cerebral MRI showed diffuse and extensive involvement of the brainstem and cerebellar
hemispheres associated with hydrocephalus consistent with tuberculous meningoencephalitis. Antituberculous therapy
was started, but no clinical improvement was achieved.