{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:00:36Z","timestamp":1790301636187,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>An immunocompetent young male in his early 20s presented with a 1\u2010month history of central chest pain, dyspepsia and significant weight loss. Initial evaluation revealed a large, deep oesophageal ulcer and extensive necrotic mediastinal lymphadenopathy. Endobronchial ultrasound\u2010guided fine\u2010needle aspiration of the mediastinal nodes confirmed necrotising granulomatous inflammation, suggestive of tuberculosis. Following initiation of anti\u2010tuberculosis treatment (ATT), he initially showed systemic improvement. However, within 2\u2009weeks, he developed drug\u2010induced liver injury along with new\u2010onset focal neurological deficits, including right\u2010sided hemiparesis and vocal cord palsy. Neuroimaging revealed multiple new intracranial lesions involving the left temporal lobe, right posterior parietal region and brainstem, whilst repeat cross\u2010sectional imaging of the chest and abdomen was suggestive of interval improvement. A diagnosis of paradoxical isolated central nervous system tuberculosis\u2010associated immune reconstitution inflammatory syndrome was made. He was managed with high\u2010dose systemic corticosteroids and a modified hepatoprotective ATT regimen, resulting in clinical improvement.<\/jats:p>","DOI":"10.1002\/rcr2.70728","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:21:36Z","timestamp":1788416496000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Isolated Central Nervous System Tuberculosis\u2010Associated Immune Reconstitution Inflammatory Syndrome\u2014Case Report and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9585-4353","authenticated-orcid":false,"given":"Mithen","family":"Ravisankar","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine Christian Medical College, Vellore (Ranipet Campus)  Vellore 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