A Case Report of concurrent SARS-CoV-2 infection and multi-drug-resistant tuberculous meningitis

Infrequently documented, drug-resistant tuberculous meningitis presents diagnostic and treatment challenges, particularly during SARS-CoV-2 coinfection. Timely identification is crucial to prevent severe complications, yet the optimal treatment course remains uncertain, marked by elevated morbidity and mortality rates. Standard guidelines recommend at least four potent secondline anti-TB drugs. Amid a pandemic, it’s vital not to solely focus on COVID-19 but to explore various aspects. This case outlines a 20-year-old with multi-drug-resistant tuberculous meningitis and SARS-CoV-2, in contact with an MDR pulmonary tuberculosis case. Diagnosis involved molecular and bacteriological cerebrospinal fluid examinations. GeneXpert MTB/RIF revealed rifampicin resistance, and subsequent testing indicated TB resistance to multiple drugs. Tuberculous meningitis, a predominant manifestation, demands careful attention for accurate diagnosis and strategic management. The judicious selection and duration of efficacious drugs are pivotal in treating MDR tuberculous meningitis.