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We describe a case of 78-year-old woman with a 1-week history of fever and left hemiparesis. Head magnetic resonance imaging showed a small infarct. After admission, she showed altered consciousness and another small infarct. She finally had diagnoses of miliary tuberculosis (miliary-TB) and tuberculous meningitis (TBM). She recovered after receiving anti-tuberculous therapy (ATT) with prednisolone. However, 5 weeks later, we found another infarct. This is a rare case of TBM with recurrent infarcts in atypical lesions in spite of ATT. We suggest the possibility that the new infarct after ATT was due to a paradoxical reaction.


Hiroshi Morioka, Shuuichi Matsumoto, Eiji Kojima, Kazuto Takada, Susumu Iwata, Shoutaro Okachi. Paradoxical infarct in tuberculous meningitis: a case report. Internal medicine (Tokyo, Japan). 2012;51(8):949-51

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PMID: 22504257

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