{"id":"https://openalex.org/W7225100915","doi":"https://doi.org/10.1155/crrh/8150858","title":"A Case of SLE Flare With Class IV Lupus Nephritis and Tuberculous Meningitis Presenting as Neuropsychiatric Symptoms: A Diagnostic Dilemma","display_name":"A Case of SLE Flare With Class IV Lupus Nephritis and Tuberculous Meningitis Presenting as Neuropsychiatric Symptoms: A Diagnostic Dilemma","publication_year":2026,"publication_date":"2026-01-01","ids":{"openalex":"https://openalex.org/W7225100915","doi":"https://doi.org/10.1155/crrh/8150858","pmid":"https://pubmed.ncbi.nlm.nih.gov/42974234","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13725705"},"language":"en","primary_location":{"id":"doi:10.1155/crrh/8150858","doi":"https://doi.org/10.1155/crrh/8150858","is_oa":true,"landing_page_url":"https://doi.org/10.1155/crrh/8150858","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/crrh/8150858","source":{"id":"https://openalex.org/S2764880244","display_name":"Case Reports in Rheumatology","issn_l":"2090-6889","issn":["2090-6889","2090-6897"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310319869","host_organization_name":"Hindawi Publishing Corporation","host_organization_lineage":["https://openalex.org/P4310319869","https://openalex.org/P4310320595"],"host_organization_lineage_names":["Hindawi Publishing Corporation","Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Case Reports in Rheumatology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/crrh/8150858","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5022082229","display_name":"G P Bhandari","orcid":"https://orcid.org/0009-0009-1902-7661","observed_orcids":["https://orcid.org/0009-0009-1902-7661"]},"institutions":[{"id":"https://openalex.org/I4405258250","display_name":"Maharajgunj Medical Campus","ror":"https://ror.org/00bzk5h02","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405258250","https://openalex.org/I4405260107"]},{"id":"https://openalex.org/I4405260107","display_name":"Institute of Medicine","ror":"https://ror.org/038ymyw44","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405260107"]}],"countries":["NP"],"is_corresponding":true,"raw_author_name":"Govinda Bhandari","raw_affiliation_strings":["Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal"],"raw_orcid":"https://orcid.org/0009-0009-1902-7661","affiliations":[{"raw_affiliation_string":"Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal","institution_ids":["https://openalex.org/I4405258250","https://openalex.org/I4405260107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110066618","display_name":"Apekshya Chhetri","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405258250","display_name":"Maharajgunj Medical Campus","ror":"https://ror.org/00bzk5h02","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405258250","https://openalex.org/I4405260107"]},{"id":"https://openalex.org/I4405260107","display_name":"Institute of Medicine","ror":"https://ror.org/038ymyw44","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405260107"]}],"countries":["NP"],"is_corresponding":false,"raw_author_name":"Anupam Katuwal Chhetri","raw_affiliation_strings":["Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal","institution_ids":["https://openalex.org/I4405258250","https://openalex.org/I4405260107"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5091504845","display_name":"Rajan Gyawali","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210119140","display_name":"Tribhuvan University Teaching Hospital","ror":"https://ror.org/02me73n88","country_code":"NP","type":"healthcare","lineage":["https://openalex.org/I4210119140"]}],"countries":["NP"],"is_corresponding":false,"raw_author_name":"Rajan Gyawali","raw_affiliation_strings":["Department of Internal Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal  teachinghospital.org.np"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine Tribhuvan University Teaching Hospital  Kathmandu Nepal  teachinghospital.org.np","institution_ids":["https://openalex.org/I4210119140"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5117736867","display_name":"Binay Chapagain","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405258250","display_name":"Maharajgunj Medical Campus","ror":"https://ror.org/00bzk5h02","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405258250","https://openalex.org/I4405260107"]},{"id":"https://openalex.org/I4405260107","display_name":"Institute of Medicine","ror":"https://ror.org/038ymyw44","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405260107"]}],"countries":["NP"],"is_corresponding":false,"raw_author_name":"Binay Chapagain","raw_affiliation_strings":["Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal","institution_ids":["https://openalex.org/I4405258250","https://openalex.org/I4405260107"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5158713949","display_name":"Anush Acharya","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4405258250","display_name":"Maharajgunj Medical Campus","ror":"https://ror.org/00bzk5h02","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405258250","https://openalex.org/I4405260107"]},{"id":"https://openalex.org/I4405260107","display_name":"Institute of Medicine","ror":"https://ror.org/038ymyw44","country_code":"NP","type":"education","lineage":["https://openalex.org/I155028946","https://openalex.org/I4405260107"]}],"countries":["NP"],"is_corresponding":false,"raw_author_name":"Anush Acharya","raw_affiliation_strings":["Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal","institution_ids":["https://openalex.org/I4405258250","https://openalex.org/I4405260107"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5022082229"],"corresponding_institution_ids":["https://openalex.org/I4405258250","https://openalex.org/I4405260107"],"apc_list":{"value":790,"currency":"USD","value_usd":790},"apc_paid":{"value":790,"currency":"USD","value_usd":790},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.85416771,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"2026","issue":"1","first_page":"8150858","last_page":"8150858"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10308","display_name":"Systemic Lupus Erythematosus Research","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11029","display_name":"Renal Diseases and Glomerulopathies","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2727","display_name":"Nephrology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/systemic-lupus-erythematosus","display_name":"systemic lupus erythematosus","score":0.9860000014305115},{"id":"https://openalex.org/keywords/lupus-nephritis","display_name":"lupus nephritis","score":0.8069999814033508},{"id":"https://openalex.org/keywords/tuberculous-meningitis","display_name":"tuberculous meningitis","score":0.9350000023841858},{"id":"https://openalex.org/keywords/neuropsychiatric-systemic-lupus-erythematosus","display_name":"neuropsychiatric lupus","score":0.9430000185966492},{"id":"https://openalex.org/keywords/differential-diagnosis","display_name":"differential diagnosis","score":0.5370000004768372},{"id":"https://openalex.org/keywords/seizures","display_name":"seizures","score":0.36800000071525574},{"id":"https://openalex.org/keywords/cerebrospinal-fluid-biomarkers","display_name":"cerebrospinal fluid biomarkers","score":0.777999997138977},{"id":"https://openalex.org/keywords/adenosine-deaminase","display_name":"adenosine deaminase","score":0.8429999947547913},{"id":"https://openalex.org/keywords/immunosuppression","display_name":"immunosuppression","score":0.5630000233650208},{"id":"https://openalex.org/keywords/granuloma","display_name":"granuloma","score":0.4180000126361847},{"id":"https://openalex.org/keywords/renal-flares","display_name":"renal flares","score":0.32100000977516174}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9107000231742859},{"id":"https://openalex.org/C2776896556","wikidata":"https://www.wikidata.org/wiki/Q3854687","display_name":"Tuberculous meningitis","level":3,"score":0.6388999819755554},{"id":"https://openalex.org/C2776912625","wikidata":"https://www.wikidata.org/wiki/Q1485","display_name":"Systemic lupus erythematosus","level":3,"score":0.46369999647140503},{"id":"https://openalex.org/C2779912601","wikidata":"https://www.wikidata.org/wiki/Q1621830","display_name":"Lupus nephritis","level":3,"score":0.4634000062942505},{"id":"https://openalex.org/C2781069245","wikidata":"https://www.wikidata.org/wiki/Q12204","display_name":"Tuberculosis","level":2,"score":0.45829999446868896},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.4553000032901764},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.4433000087738037},{"id":"https://openalex.org/C2781026528","wikidata":"https://www.wikidata.org/wiki/Q48143","display_name":"Meningitis","level":2,"score":0.39649999141693115},{"id":"https://openalex.org/C2779651940","wikidata":"https://www.wikidata.org/wiki/Q54196","display_name":"Cerebrospinal fluid","level":2,"score":0.3684000074863434},{"id":"https://openalex.org/C2780636500","wikidata":"https://www.wikidata.org/wiki/Q6708259","display_name":"Lymphocytic pleocytosis","level":4,"score":0.35569998621940613},{"id":"https://openalex.org/C2780066322","wikidata":"https://www.wikidata.org/wiki/Q719444","display_name":"Lumbar puncture","level":3,"score":0.35420000553131104},{"id":"https://openalex.org/C206179267","wikidata":"https://www.wikidata.org/wiki/Q188952","display_name":"Medical history","level":2,"score":0.3409999907016754},{"id":"https://openalex.org/C2780505380","wikidata":"https://www.wikidata.org/wiki/Q7142931","display_name":"Past medical history","level":2,"score":0.3407000005245209},{"id":"https://openalex.org/C2780645631","wikidata":"https://www.wikidata.org/wiki/Q671554","display_name":"Stroke (engine)","level":2,"score":0.3158000111579895},{"id":"https://openalex.org/C2781087799","wikidata":"https://www.wikidata.org/wiki/Q7312483","display_name":"Renal biopsy","level":3,"score":0.3019999861717224},{"id":"https://openalex.org/C2776429142","wikidata":"https://www.wikidata.org/wiki/Q1620189","display_name":"Brain biopsy","level":3,"score":0.2935999929904938},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.2928999960422516},{"id":"https://openalex.org/C2781301800","wikidata":"https://www.wikidata.org/wiki/Q193894","display_name":"Sarcoidosis","level":2,"score":0.28439998626708984},{"id":"https://openalex.org/C146638467","wikidata":"https://www.wikidata.org/wiki/Q10529587","display_name":"Hyperintensity","level":3,"score":0.2793999910354614},{"id":"https://openalex.org/C2777840918","wikidata":"https://www.wikidata.org/wiki/Q1753520","display_name":"Rheumatoid nodule","level":3,"score":0.27799999713897705},{"id":"https://openalex.org/C2775915377","wikidata":"https://www.wikidata.org/wiki/Q188297","display_name":"Lupus erythematosus","level":3,"score":0.2773999869823456},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.2766000032424927},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.2727999985218048},{"id":"https://openalex.org/C2777165109","wikidata":"https://www.wikidata.org/wiki/Q388169","display_name":"Malar rash","level":5,"score":0.26980000734329224},{"id":"https://openalex.org/C2781192897","wikidata":"https://www.wikidata.org/wiki/Q822050","display_name":"White matter","level":3,"score":0.2694999873638153},{"id":"https://openalex.org/C2779561371","wikidata":"https://www.wikidata.org/wiki/Q570197","display_name":"Proteinuria","level":3,"score":0.2583000063896179},{"id":"https://openalex.org/C2778248108","wikidata":"https://www.wikidata.org/wiki/Q5445","display_name":"Anemia","level":2,"score":0.25760000944137573}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.1155/crrh/8150858","doi":"https://doi.org/10.1155/crrh/8150858","is_oa":true,"landing_page_url":"https://doi.org/10.1155/crrh/8150858","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/crrh/8150858","source":{"id":"https://openalex.org/S2764880244","display_name":"Case Reports in Rheumatology","issn_l":"2090-6889","issn":["2090-6889","2090-6897"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310319869","host_organization_name":"Hindawi Publishing Corporation","host_organization_lineage":["https://openalex.org/P4310319869","https://openalex.org/P4310320595"],"host_organization_lineage_names":["Hindawi Publishing Corporation","Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Case Reports in Rheumatology","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13725705","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13725705/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13725705/pdf/CRRH-2026-8150858.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Case Rep Rheumatol","raw_type":"Text"},{"id":"pmid:42974234","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42974234","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Case reports in rheumatology","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1155/crrh/8150858","doi":"https://doi.org/10.1155/crrh/8150858","is_oa":true,"landing_page_url":"https://doi.org/10.1155/crrh/8150858","pdf_url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1155/crrh/8150858","source":{"id":"https://openalex.org/S2764880244","display_name":"Case Reports in Rheumatology","issn_l":"2090-6889","issn":["2090-6889","2090-6897"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj"],"host_organization":"https://openalex.org/P4310319869","host_organization_name":"Hindawi Publishing Corporation","host_organization_lineage":["https://openalex.org/P4310319869","https://openalex.org/P4310320595"],"host_organization_lineage_names":["Hindawi Publishing Corporation","Wiley"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Case Reports in Rheumatology","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225100915.pdf","grobid_xml":"https://content.openalex.org/works/W7225100915.grobid-xml"},"referenced_works_count":16,"referenced_works":["https://openalex.org/W1987846149","https://openalex.org/W2014074083","https://openalex.org/W2018973039","https://openalex.org/W2019740973","https://openalex.org/W2072362309","https://openalex.org/W2074412614","https://openalex.org/W2080260624","https://openalex.org/W2147457110","https://openalex.org/W2150492824","https://openalex.org/W2169076185","https://openalex.org/W3003150189","https://openalex.org/W3130113466","https://openalex.org/W3174870979","https://openalex.org/W4306654969","https://openalex.org/W4399325290","https://openalex.org/W4401847647"],"related_works":["https://openalex.org/W7140277007","https://openalex.org/W3174870979","https://openalex.org/W7165492622","https://openalex.org/W2938222750","https://openalex.org/W2019740973","https://openalex.org/W4392462429","https://openalex.org/W4384700048","https://openalex.org/W4385406761","https://openalex.org/W3029198165","https://openalex.org/W2380064568"],"abstract_inverted_index":{"Background:":[0],"Systemic":[1],"lupus":[2,127],"erythematosus":[3],"(SLE)":[4],"is":[5,35,46],"a":[6,64,80,207],"multisystem":[7],"autoimmune":[8],"disease":[9],"with":[10,63,70,237,287],"potential":[11],"neuropsychiatric":[12,288],"involvement":[13],"(NPSLE)":[14],"and":[15,53,79,104,119,132,151,165,176,190,206,217,232,256,270,312],"increased":[16],"susceptibility":[17],"to":[18,50],"opportunistic":[19],"infections":[20,247],"like":[21],"tuberculosis":[22],"(TB),":[23],"particularly":[24],"in":[25,201,290],"endemic":[26,260],"regions":[27],"such":[28],"as":[29],"Nepal":[30],"where":[31],"the":[32,202],"estimated":[33],"incidence":[34],"229":[36],"per":[37],"100,000":[38],"population.":[39],"Differentiating":[40],"NPSLE":[41,244],"from":[42,245],"tuberculous":[43],"meningitis":[44],"(TBM)":[45],"diagnostically":[47],"challenging":[48],"due":[49],"overlapping":[51],"clinical":[52,269],"cerebrospinal":[54],"fluid":[55],"(CSF)":[56],"findings.":[57,258],"Case":[58],"Presentation:":[59],"A":[60],"25-year-old":[61],"male":[62],"1-year":[65],"history":[66,82],"of":[67,83,182,240,251],"SLE":[68,285],"presented":[69],"facial":[71],"puffiness,":[72],"oral":[73],"ulcers,":[74],"polyarthritis,":[75],"lower":[76],"limb":[77],"edema,":[78],"6-week":[81],"renal":[84,233],"symptoms.":[85],"Laboratory":[86],"investigations":[87],"revealed":[88,155],"microcytic":[89],"anemia":[90],"(Hb":[91],"7.4":[92],"g/dL),":[93],"nephrotic-range":[94],"proteinuria":[95],"(urine":[96],"protein-to-creatinine":[97],"ratio":[98],"4.8":[99],"g/g),":[100],"strongly":[101],"positive":[102,111],"anti-dsDNA,":[103],"low":[105,172],"complement":[106],"levels.":[107],"ENA":[108],"panel":[109],"was":[110,224],"for":[112,116,143],"anti-Ro/SSA":[113],"but":[114],"negative":[115,185],"antiribosomal":[117],"P":[118],"antiphospholipid":[120],"antibodies.":[121],"Renal":[122],"biopsy":[123],"confirmed":[124],"class":[125],"IV":[126],"nephritis":[128],"(Activity":[129],"Index":[130,134],"11/24":[131],"Chronicity":[133],"3/12).":[135],"Following":[136],"intravenous":[137],"methylprednisolone":[138],"pulse":[139],"therapy":[140,222],"(500":[141,163],"mg/day":[142],"3":[144],"days),":[145],"he":[146],"developed":[147],"generalized":[148],"tonic-clonic":[149],"seizures":[150],"altered":[152],"sensorium.":[153],"EEG":[154],"epileptiform":[156],"discharges.":[157],"CSF":[158,253],"analysis":[159],"showed":[160,196],"lymphocytic":[161],"pleocytosis":[162],"cells/\u03bcL":[164],"80%":[166],"lymphocytes),":[167],"elevated":[168,177],"protein":[169],"(578":[170],"mg/dL),":[171],"glucose":[173],"(1.4":[174],"mmol/L),":[175],"ADA":[178],"(10.9":[179],"U/L),":[180],"suggestive":[181],"TBM":[183,296],"despite":[184],"GeneXpert":[186],"MTB/RIF,":[187],"viral":[188],"PCR,":[189],"cryptococcal":[191],"antigen":[192],"assays.":[193],"MRI":[194,257],"brain":[195],"cerebral":[197],"atrophy,":[198],"calcified":[199],"granulomas":[200],"right":[203],"temporal":[204],"lobe,":[205],"nonspecific":[208],"demyelinating":[209],"white":[210],"matter":[211],"lesion.":[212],"Based":[213],"on":[214],"clinical,":[215],"CSF,":[216],"imaging":[218],"findings,":[219],"empirical":[220,262,305],"antitubercular":[221],"(ATT)":[223],"initiated":[225,266],"alongside":[226],"tailored":[227],"immunosuppression.":[228],"The":[229],"patient's":[230],"neurological":[231],"status":[234],"markedly":[235],"improved":[236],"complete":[238],"resolution":[239],"seizures.":[241],"Discussion:":[242],"Distinguishing":[243],"CNS":[246],"requires":[248],"careful":[249],"evaluation":[250],"serial":[252],"parameters,":[254],"biomarkers,":[255],"In":[259,284],"regions,":[261],"ATT":[263],"should":[264],"be":[265],"early":[267],"when":[268,276,298],"laboratory":[271],"features":[272],"suggest":[273],"TBM,":[274],"even":[275,297],"molecular":[277],"or":[278],"culture":[279],"tests":[280,301],"are":[281,302],"negative.":[282,303],"Conclusion:":[283],"patients":[286],"symptoms":[289],"TB-endemic":[291],"areas,":[292],"clinicians":[293],"must":[294],"consider":[295],"definitive":[299],"microbiological":[300],"Early":[304],"treatment":[306],"can":[307],"significantly":[308],"improve":[309],"patient":[310],"survival":[311],"long-term":[313],"outcomes.":[314]},"counts_by_year":[],"updated_date":"2026-11-06T12:05:46.655746","created_date":"2026-11-03T00:00:00"}
