MP Journal of Medical Research
Presented at 13ème Congrès Somipev-Zerouali, Marrakech, 5–7 December 2025 · All posters from this congress
PediatricsOpen accessPoster communication · 2026-0025

What if neurosarcoidosis was actually tuberculosis?

English version of a poster presented in French.

Djodjo Mbiyuku1✉, K. Weyo1, G. Bennani1, F. Harim1, K. Chbani2, F. Ailal3, I. Chahib3

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Received 9 October 2026 · Accepted 9 October 2026 · Published 9 October 2026

DOI: https://doi.org/10.5281/zenodo.23349270

Article PDF · Original poster (PDF)

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Key messages

  1. La méningite tuberculeuse et la neurosarcoïdose partagent de nombreux éléments cliniques, biologiques et radiologiques.
  2. Le diagnostic différentiel est complexe et une erreur diagnostique peut avoir des conséquences graves.
  3. Un examen anatomopathologique est essentiel pour confirmer la nature granulomateuse et orienter le traitement.

Abstract

Introduction

Tuberculous meningitis remains a frequent cause of chronic meningitis in endemic countries. Some non-infectious granulomatous diseases, such as neurosarcoidosis, can closely mimic the clinical and radiological presentation, complicating differential diagnosis.

Materials and methods

Case report of a 13-year-old boy admitted for febrile intracranial hypertension syndrome with seizures. CSF analysis showed high protein, high glucose, and absence of Mycobacterium tuberculosis. Initial brain MRI suggested tuberculous meningitis. After no improvement with anti-tuberculous treatment, brain and spinal MRI showed diffuse leptomeningeal involvement. Neurosarcoidosis diagnosis was made after exclusion and treatment with corticosteroids and immunosuppressants.

Results

The patient showed notable clinical improvement after immunosuppressive treatment. Imaging revealed meningeal nodular lesions suggesting a non-infectious granulomatous cause. Etiological workup showed persistent high protein in CSF without Mycobacterium tuberculosis. Chest CT was normal.

Conclusion

This case illustrates the diagnostic challenge between tuberculous meningitis and neurosarcoidosis, especially in tuberculosis endemic areas, and highlights the importance of pathological examination to confirm the granulomatous nature of the infiltrate.

Original poster

References

  1. Pawar S et al. Clinical profile of tuberculous meningitis. Neurol India. 2017.
  2. Bathla G et al. Differentiating CNS sarcoidosis from TB. Acta Radiologica. 2018
  3. Boudjarane MA et al. Diagnostic pitfalls of neurosarcoidosis in TB-endemic regions. Pan Afr Med J. 2021
  4. Sharma SK, Mohan A. TB in high-burden countries. Indian J Med Res. 2019
Keywords
tuberculous meningitis · neurosarcoidosis · differential diagnosis · brain imaging · granulomatous disease
Received
9 October 2026
Accepted
9 October 2026
Published
9 October 2026
Peer review
Single-anonymized review by the Editorial Board · How we review
DOI
https://doi.org/10.5281/zenodo.23349270
License
© The Authors 2026. Distributed under CC BY 4.0
Journal
MP Journal of Medical Research · ISSN 3144-8402

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