OJCD  Vol.11 No.2 , June 2021
Tuberculous Meningitis and COVID-19 Co-Infection: About a Case
Show more
Abstract: We report the case of an adult patient diagnosed with acute SARS-CoV-2-associated meningoencephalitis based on the detection of its RNA on a nasopharyngeal swab, cerebrospinal fluid analysis. The most destructive type of extrapulmonary tuberculosis is tuberculous meningitis, in which the consequences are severe, resulting in death or disability in almost half of all sufferers despite anti-tuberculosis chemotherapy. The aim of this study was to assess the clinical and paraclinical features and laboratory findings and outcome of a patient with tuberculous meningitis and COVID-19 coinfection. Infection of COVID-19 and lymphopenia promotes the development of the severe form of tuberculosis. On the other hand, TBM increased the risk of infection with coronavirus due to the weakened immune system in addition to other immunosuppressive factors (older age and comorbidities such as low socioeconomic status and malnutrition). The patient had a good recovery even if he required intensive neurorehabilitation for a month due to poor feeding and weakness. Treatment, both anti-mycobacterial and anti-inflammatory, early started, guaranteed good recovery.
Cite this paper: Maaroufi, A. , Diai, A. , Jebbar, N. , Bibiche, L. , Jaber, K. , Jbili, N. , Kechna, H. and Laoutid, J. (2021) Tuberculous Meningitis and COVID-19 Co-Infection: About a Case. Open Journal of Clinical Diagnostics, 11, 52-58. doi: 10.4236/ojcd.2021.112004.

[1]   Worldometers (2020) COVID-19 Coronavirus Pandemic.

[2]   Vitacca, M., Nava, S., Santus, P., et al. (2020) Early Consensus Management for Non-ICU ARF SARS-CoV-2 Emergency in Italy: From Ward to Trenches. European Respiratory Journal.

[3]   Sustainable Development Goals [Website]. United Nations, New York.

[4]   Thwaites, G.E., van Toorn, R. and Schoeman, J. (2013) Tuberculous Meningitis: More Questions, Still Too Few Answers. The Lancet Neurology, 12, 999-1010.


[6]   Près de 30.000 cas de tuberculose sont enregistrés chaque année au Maroc, y compris les nouveaux cas et les cas de rechute.

[7]   Katti, M.K. (2004) Pathogenesis, Diagnosis, Treatment, and Outcome Aspects of Cerebral Tuberculosis. Medical Science Monitor, 10, RA215-RA229.

[8]   Kent, S.J., Crowe, S.M., Yung, A., Lucas, C.R. and Mijch, A.M. (1993) Tuberculous Meningitis: A 30-Year Review. Clinical Infectious Diseases, 17, 987-994.

[9]   Boyles, T.H. and Thwaites, G.E. (2015) Appropriate Use of the Xpert(R) MTB/RIF Assay in Suspected Tuberculous Meningitis. International Journal of Tuberculosis and Lung Disease, 19, 276-277.

[10]   Bahr, N.C., Marais, S., Caws, M., et al. (2016) Tuberculous Meningitis International Research C: GeneXpert MTB/Rif to Diagnose Tuberculous Meningitis: Perhaps the First Test But Not the Last. Clinical Infectious Diseases, 62, 1133-1135.

[11]   Panteleev, A.V., Nikitina, I.Y., Burmistrova, I.A., Kosmiadi, G.A., Radaeva, T.V., Amansahedov, R.B., et al. (2017) Severe Tuberculosis in Humans Correlates Best with Neutrophil Abundance and Lymphocyte Deficiency and Does Not Correlate with Antigen-Specific CD4 T-Cell Response. Frontiers in Immunology, 8, 963.

[12]   Lin, W. and Chen, P. (2020) Tubercular Meningitis in Patients with Systemic Lupus Erythematosus: Clinical Characteristics, Risk Factors, and Outcomes of 10 Patients. Clinical Rheumatology, 39, 1141-1145.

[13]   Pathak, S., Wentzel-Larsen, T. and Åsjö, B. (2010) Effects of in Vitro HIV-1 Infection on Mycobacterial Growth in Peripheral Blood Monocyte-Derived Macrophages. Infection and Immunity, 78, 4022-4032.

[14]   Whittaker, E., López-Varela, E., Broderick, C. and Seddon, J.A. (2019) Examining the Complex Relationship between Tuberculosis and Other Infectious Diseases in Children. Frontiers in Pediatrics, 7, 233.

[15]   Melzer, M., Brown, T., Flood, J., Lacey, S. and Bagg, L. (1999) False Negative Polymerase Chain Reaction on Cerebrospinal Fluid Samples in Tuberculous Meningitis Established by Culture. Journal of Neurology, Neurosurgery and Psychiatry, 67, 249-250.

[16]   (2014) Recommandation de la Société de pneumologie de langue française sur la prise en charge de la tuberculose en France.,108-.html

[17]   American Thoracic Society, Center for Disease Control and Prevention, Infectious Disease Society of America (2003) Treatment of Tuberculosis. American Journal of Respiratory and Critical Care Medicine, 167, 603-662.

[18]   Marais, S., Thwaites, G., Schoeman, J.F., Török, M.E., Misra, U.K., Prasad, K., et al. (2010) Tuberculous Meningitis: A Uniform Case Definition for Use in Clinical Research. The Lancet Infectious Diseases, 10, 803-812.

[19]   Visca, D., Zampogna, E., Sotgiu, G., Centis, R., Saderi, L., D’Ambrosio, L., Pegoraro, V., Pignatti, P., Muňoz-Torrico, M., Migliori, G.B. and Spanevello, A. (2019) Pulmonary Rehabilitation Is Effective in Patients with Tuberculosis Pulmonary Sequelae. European Respiratory Journal, 53, Article ID: 1802184.

[20]   Visca, D., Tiberi, S., Pontali, E., Spanevello, A. and Migliori, G.B. (2020) Tuberculosis in the Time of COVID-19: Quality of Life and Digital Innovation. European Respiratory Journal, 56, Article ID: 2001998.