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We prospectively characterised the immune response of 160 TBM suspects in an Indonesian cohort, including 67 HIV-negative probable or definite TBM cases. TBM patients presented with severe disease and 38% died in 6 months. Blood from TBM patients analysed by flow cytometry showed lower \u03b1\u03b2T and \u03b3\u03b4T cells, NK cells and MAIT cells compared to 26 pulmonary tuberculosis patients (2.4-4-fold, all p\u2009&lt;\u20090.05) and 27 healthy controls (2.7-7.6-fold, p\u2009&lt;\u20090.001), but higher neutrophils and classical monocytes (2.3-3.0-fold, p\u2009&lt;\u20090.001). CSF leukocyte activation was higher than in blood (1.8-9-fold). CSF of TBM patients showed a predominance of \u03b1\u03b2T and NK cells, associated with better survival. Cytokine production after <jats:italic>ex-vivo<\/jats:italic> stimulation of whole blood showed a much broader range in TBM compared to both control groups (p\u2009&lt;\u20090.001). Among TBM patients, high <jats:italic>ex-vivo<\/jats:italic> production of TNF-\u03b1, IL-6 and IL-10 correlated with fever, lymphocyte count and monocyte HLA-DR expression (all p\u2009&lt;\u20090.05). TBM patients show a strong myeloid blood response, with a broad variation in immune function. 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