A pt presents with gradual onset of headache, neck stiffness, photophobia and fluctuating LOC.
CSF shows lymphocytosis but no organism on gram stain. CT brain is normal. What is the single
most likely dx?
a. Hairy leukoplakia
c. CMV infection
d. Candida infection
e. Cryptococcal infection
Ans. The key is B. TB. [Enhancing mass lesions caused by CMV infection have been reported only in patients with advanced acquired immune deficiency syndrome (AIDS). Fungal meningitis can also present like this but it is much more rare. Moreover negative gram stain excludes fungal cause here. Hence TB meningitis is more acceptable answer].