{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:26:56Z","timestamp":1773782816908,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":306,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"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":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    A 22\u2010year\u2010old man presented with headache, night sweats, intermittent fever, tremors, sleep disturbances, agitation, and hallucinations for 2\u2009months. Thoracic computed tomography (CT) showed widespread interstitial nodular lesions, but initial cranial CT showed no significant pathology. Cerebrospinal fluid (CSF) analysis revealed 25\u2009cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    of white blood cells (72% neutrophils), 83\u2009mg\/dL protein, and 30\u2009mg\/dL glucose (concurrent serum glucose was 103\u2009mg\/dL). Gram and Ziehl\u2013Neelsen stains were negative for acid\u2010fast bacilli. Tuberculosis (TB) cultures and Mycobacterium PCR tests remained negative. Biopsy of the bronchoalveolar lavage sample showed necrotizing granulomatous inflammation, and the\n                    <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                    PCR result was positive. During the first month of first\u2010line anti\u2010TB treatment, the patient experienced recurrent severe headaches, persistent fever, and decreased visual acuity. Contrast\u2010enhanced MRI revealed lesions that were consistent with tuberculous meningitis (TBM). Considering the possibility of drug\u2010resistant TB, streptomycin 1 gr\/qd (quaque die) intramuscularly and linezolid 600\u2009mg\/bid (bid in die) intravenously were added to the regimen. The patient\u2019s symptoms persisted during the second month of treatment. The patient experienced epileptic seizures. The control MRI showed an enlargement of the lesions. A paradoxical reaction was considered. Intravenous methylprednisolone 500\u2009mg\/day was initiated. The patient did not respond clinically, and his complaints continued. The patient was started on the IL\u20101 inhibitor anakinra. Paradoxical inflammatory reactions are common in TBM but challenging to predict. When severe, they can lead to significant neurological morbidity and death. This article aimed to share a case that did not respond to corticosteroids, a standard treatment for paradoxical reactions, but was successfully managed with the IL\u20101 inhibitor anakinra.\n                  <\/jats:p>","DOI":"10.1155\/crdi\/8891508","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T05:09:43Z","timestamp":1762232983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tuberculous Meningitis With Paradoxical Reaction in an Immunocompetent Young Male Treated by Interleukin\u20101 Receptor Antagonist"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2499-0101","authenticated-orcid":false,"given":"Azade","family":"Kanat","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6775-1234","authenticated-orcid":false,"given":"Ay\u015fin K\u0131l\u0131n\u00e7","family":"Toker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6138-2426","authenticated-orcid":false,"given":"Zuhal","family":"\u00d6zer \u015eim\u015fek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0296-4914","authenticated-orcid":false,"given":"Ali","family":"Ko\u00e7","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2604-3776","authenticated-orcid":false,"given":"Ilhami","family":"Celik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"e_1_2_8_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2020.02.005"},{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5875628"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.03.025"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(80)91676-1"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1625-9"},{"key":"e_1_2_8_6_2","first-page":"234","article-title":"Intracranial Tuberculomas in Patients With Tuberculous Meningitis: Predictors and Prognostic Significance","volume":"15","author":"Anuradha H. K.","year":"2011","journal-title":"International Journal of Tuberculosis & Lung Disease"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00042-07"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0556"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000001997"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/500459"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medj.2022.07.001"}],"container-title":["Case Reports in Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdi\/8891508","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crdi\/8891508","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdi\/8891508","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:54:37Z","timestamp":1773770077000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crdi\/8891508"}},"subtitle":[],"editor":[{"given":"Rajib","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crdi\/8891508"],"URL":"https:\/\/doi.org\/10.1155\/crdi\/8891508","archive":["Portico"],"relation":{},"ISSN":["2090-6625","2090-6633"],"issn-type":[{"value":"2090-6625","type":"print"},{"value":"2090-6633","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8891508"}}