{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T13:51:09Z","timestamp":1787061069237,"version":"build-2736575974"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,2,20]],"date-time":"2022-02-20T00:00:00Z","timestamp":1645315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Tuberculous meningitis (TBM) is a rare but important differential diagnosis in patients with impaired consciousness. Here, we describe a case of TBM in an 83\u2010year\u2010old Japanese woman who presented to a local hospital with fever and decreased consciousness of 20\u2009days' duration (from day \u221240). She was started on treatment for bacterial meningitis due to an increased cerebrospinal fluid cell count, but her condition did not improve. She was transferred to a second hospital on suspicion for cholecystitis, then to a university hospital when consciousness did not improve and finally to us at a fourth hospital. On day \u22122, diffuse granulation was seen in both lung fields on chest computed tomography, sputum Mycobacterium test was positive and adenosine deaminase was elevated in spinal fluid. We diagnosed TBM secondary to miliary tuberculosis and started treatment with steroids and anti\u2010tuberculous drugs (day 0). However, her level of consciousness did not improve and she died at a sanatorium on day 178. Delayed treatment of TBM has a prognostic impact and should be kept in mind as a differential diagnosis for impaired consciousness.<\/jats:p>","DOI":"10.1002\/rcr2.910","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T02:54:46Z","timestamp":1645412086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The challenge of differentiating tuberculous meningitis from bacterial meningitis"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-0114","authenticated-orcid":false,"given":"Momoko","family":"Kurihara","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"},{"name":"Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonori","family":"Kuroki","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushi","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otohiro","family":"Katsube","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Umetsu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Numao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Generalist Medicine Dokkyo Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0624-946X","authenticated-orcid":false,"given":"Kumiya","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital  Tochigi Japan"},{"name":"Department of Respiratory Medicine and Clinical Immunology Dokkyo Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-6757(96)90080-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040573"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-019-0966-8"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.TNMI7-0013-2016"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70138-9"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2008.03.002"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12099"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70168-6"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.910","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.910","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T13:22:55Z","timestamp":1693142575000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.910"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,20]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1002\/rcr2.910"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.910","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,20]]},"assertion":[{"value":"2022-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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