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Year : 2020  |  Volume : 11  |  Issue : 3  |  Page : 154-156

Dual infection of the brain, varicella zoster and tuberculosis in an immunocompetent adult: A rare scenario

Department of Neurology, St Stephen's Hospital, Delhi, India

Correspondence Address:
Dr. Gaurav Kumar Mittal
Department of Neurology, St Stephen's Hospital, Delhi - 110 054
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJMS.INJMS_24_20

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The spectrum of central nervous system diseases caused by mycobacterium tuberculosis (TB) and herpes virus is broad and overlapping, ranging from self-limiting meningitis to life-threatening encephalitis. In a country like India where TB is a common infection of the brain, antitubercular therapy finds itself as frontline empirical therapy in appropriate clinical scenarios. In this case report, we describe a challenging case of a middle-aged immunocompetent male whose cerebrospinal fluid came positive for herpes zoster which aided us in diagnosing viral meningoencephalitis. However, later on, when the patient deteriorated in spite of 21 days of antiviral therapy, repeat brain imaging revealed another pathology, which was TB. We wish to highlight the fact that both these pathogens can mimic each other in clinical presentation and investigations can be misleading. One should always keep them as early differentials in appropriate clinical scenarios so as not to squander crucial time in treatment.

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