Tuberculous meningitis (TBM) is a rare but the most severe form of tuberculosis (TB). Tuberculoma is the most common intracranial finding in TBM. A 23-year-old female with a family history for TB and miliary TB and TBM presented with multiple intracranial tuberculomas and chorioretinitis “Rich foci” in eyes. The progression of the old tuberculomas and edema and presence of new tuberculomas during antituberculous treatment in months 1, 2 and 4 were evaluated as recurrent paradoxical reaction. The size of tuberculomas and edema regressed with prolonged steroid treatment. Clinical and radiological follow-up of patients with TBM is important to predict paradoxical reaction.
Keywords: Paradoxical reaction, tuberculoma, tuberculous meningitis, tuberculosis