Tuberculous Optochiasmatic Arachnoiditis

This brief case report presents a 29-year-old man with tuberculous optochiasmatic arachnoiditis, a rare complication of tuberculous meningitis. Despite ongoing treatment for gastrointestinal TB, he developed headache, blurry vision, nuchal rigidity, and papilledema. MRI revealed multiple ring-enhancing lesions near the optic structures, and CSF analysis confirmed Mycobacterium tuberculosis via nucleic acid amplification. The diagnosis was interpreted as a paradoxical reaction to therapy. Dexamethasone was added to treatment, and symptoms improved over three months.

This brief case report presents a 29-year-old man with tuberculous optochiasmatic arachnoiditis, a rare complication of tuberculous meningitis. Despite ongoing treatment for gastrointestinal TB, he developed headache, blurry vision, nuchal rigidity, and papilledema. MRI revealed multiple ring-enhancing lesions near the optic structures, and CSF analysis confirmed Mycobacterium tuberculosis via nucleic acid amplification. The diagnosis was interpreted as a paradoxical reaction to therapy. Dexamethasone was added to treatment, and symptoms improved over three months.