Ichlasul Mahdi Fardhani, Miranda Angtoni, Rea Sava Kinanti Sianturi, Sinta Nuria
Tuberculous meningitis with intraparenchymal tuberculomas represents a rare but serious form of neurotuberculosis. We describe a 14 year old female adolescent who presented with isolated abducens, sixth (VI) nerve palsy, papilloedema, and recurrent headaches. Conventional tests were inconclusive, and lumbar puncture was deferred due to raised intracranial pressure. Neuroimaging revealed diffuse cerebral oedema, basal leptomeningeal enhancement, and ring enhancing lesions, while chest X ray showed miliary infiltrates, supporting the diagnosis. Treatment with mannitol, corticosteroids, and anti tuberculosis therapy was initiated. This case highlights diagnostic challenges and underscores the critical role of imaging and timely intervention in preventing complications, particularly in high TB-burden settings. © 2026 Nepal Paediatric Society (NEPAS). All rights reserved.
Faculty of Medicine, University of Jember, Jember, Indonesia; Medicine Department, Dr. Mohammad Saleh General Hospital, Probolinggo, Indonesia; Faculty of Medicine, Tarumanagara University, Jakarta, Indonesia; Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia; Faculty of Medicine, Brawijaya University, Malang, Indonesia
