Tuberculous meningitis is a highly morbid, often fatal disease.Patient concern:
We describe a case of an Italian child.Diagnoses:
we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses.Interventions:
The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later.Outcomes:
the patient had a favorable outcome without neurologic sequelae.Lessons:
Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome.