The following is a summary of “An Elusive Case of Tuberculous Meningitis in a Young Man With Altered Mental Status” published in the October 2022 issue of Emergency Medicine by Dodson et al.

Tuberculous meningitis, more commonly referred to as Tuberculous Meningitis (TBM), is an extremely uncommon condition that can be challenging to diagnose. It is typically characterized by the absence of any particular symptoms and is connected to significant morbidity and mortality rates. Researchers present a case of TBM in a young man suffering from altered mental status and having a headache at the time of their investigation.

In addition, we present a brief history of TBM, explain the pathogenesis of the disease, discuss clinical and radiologic characteristics, and outline the treatment of TBM both in an urgent setting and throughout our patient’s hospitalization. All of this information is presented in the context of their patient. In the case of their patient, the absence of pulmonary symptoms, an initially unremarkable head computed tomography, and 2 prior evaluations for headache in the emergency department without any concerning historical features or physical examination findings.

All highlight the difficulties associated with diagnosing TBM early on in the course of its symptom course. Researchers recommend that emergency physicians check for tuberculosis bacilli in the appropriate patients, particularly those with risk factors for tuberculosis infection.