Tuberculous meningoencephalitis (TBM) is a rare and serious, often fatal presentation of active tuberculosis and
account for about 1% of cases. Early diagnosis and prompt treatment of TBM is essential to reduce morbidity and mortality.
Here, we report a case of TBM in 60-year-old man. TBM was considered on the basis of clinical presentation, laboratory
findings (hyponatraemia), cerebrospinal fluid studies, radiological findings (hydrocephalus on multi-slice computed
tomography), and history of orchiepididymitis of unknown origin one year earlier, together with information that
the patient originated from Kosovo where incidence of tuberculosis is still high. Mycobacterium tuberculosis was cultured
from cerebrospinal fluid on Lowenstein-Jensen medium confirming diagnosis of TBM. Subsequently, acid-fast bacilli
(AFB) staining on samples obtained after orchiectomy a year ago was performed, revealing AFB. Anti-tuberculosis
therapy is still in course. This is the second case of tuberculous meningoencephalitis with the same disease pattern (i.e.
tuberculous orchiepididymitis – meningoencephalitis) in our Department, and this fact was crucial for the presumptive
diagnosis and urgent treatment of TBM. The former case was described five years ago