{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:29:21Z","timestamp":1780446561327,"version":"3.54.1"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,7,30]]},"abstract":"<jats:p>We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection. Her Quantiferon-TB Gold in-tube test was negative. Cerebrospinal fluid analysis revealed a high opening pressure but no biochemical parameters to suggest TBM, hence she was treated as idiopathic intracranial hypertension. A diagnosis of TBM was finally made following a positive PCR for <jats:italic>Mycobacterium tuberculosis<\/jats:italic>. Her vision improved with reduction in optic disc swelling following antituberculous treatment.<\/jats:p>","DOI":"10.1136\/bcr-2017-221170","type":"journal-article","created":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T04:40:19Z","timestamp":1502253619000},"page":"bcr-2017-221170","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Optic disc swelling in a patient with tuberculous meningitis: a diagnostic challenge"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-677X","authenticated-orcid":false,"given":"Hanis","family":"Zuhaimy","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue Ngein","family":"Leow","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh K","family":"Vasudevan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,8,9]]},"reference":[{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1186\/s12879-016-1640-x","article-title":"Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study","volume":"16","author":"Lee","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2009.12.012"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.3","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldv003"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2009.06.011"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.5","first-page":"405","article-title":"Stages of tuberculous meningitis: a clinicoradiologic analysis","volume":"23","author":"Sher","year":"2013","journal-title":"J Coll Physicians Surg Pak"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.6","first-page":"1","article-title":"Tuberculous meningitis: diagnosis and treatment overview","volume":"2011","author":"Marx","year":"2011","journal-title":"Tuberc Res Treat"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.7","doi-asserted-by":"publisher","DOI":"10.1038\/eye.1998.18"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.8","doi-asserted-by":"publisher","DOI":"10.1097\/WNO.0b013e31821a8b0b"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.9","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3109\/01658107.2013.785573","article-title":"Fulminant idiopathic intracranial hypertension with malignant systemic hypertension-a case report","volume":"37","author":"Abbasi","year":"2013","journal-title":"Neuroophthalmology"},{"key":"2025082723245962000_2017.aug09_1.bcr-2017-221170.10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02214-07"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:25:08Z","timestamp":1756362308000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,9]]},"references-count":10,"alternative-id":["10.1136\/bcr-2017-221170"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221170","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,9]]}}}