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A 25-year-old female presented to the emergency department with a headache and fever along with multiple associated symptoms that had developed 2 days prior. Based on clinical findings, brain imaging, and cerebrospinal fluid (CSF) examination, she was tentatively diagnosed with viral meningitis. Later, she developed altered consciousness with focal seizures, and follow-up CSF examination findings and electroencephalography were consistent with NCSE complicated by TBM. We encountered a patient with TBM who exhibited initial atypical CSF findings and NCSE, and we report the case here and discuss the pathomechanisms.<\/jats:p>","DOI":"10.47936\/encephalitis.2025.00010","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T04:29:07Z","timestamp":1745814547000},"page":"67-70","update-policy":"https:\/\/doi.org\/10.47936\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tuberculous meningitis initially presented with low levels of pleocytosis and protein in the cerebrospinal fluid: a case report"],"prefix":"10.47936","volume":"5","author":[{"given":"Hyung-Kyum","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung-Kun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7498-5656","authenticated-orcid":true,"given":"Jung-Ju","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyusik","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong-Woo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilhan","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namoh","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27912","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.tnmi7-0044-2017"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/22.6.982"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1053\/jinf.2000.0692"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/nejm197309132891108"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2010.08.007"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.42.9.1809"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3109\/00365540903428158"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/dc.23284"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.283759"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2010.10.014"}],"container-title":["encephalitis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/encephalitisjournal.org\/upload\/pdf\/encephalitis-2025-00010.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/encephalitisjournal.org\/journal\/view.php?doi=10.47936\/encephalitis.2025.00010","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/encephalitisjournal.org\/upload\/pdf\/encephalitis-2025-00010.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T23:05:06Z","timestamp":1752102306000},"score":1,"resource":{"primary":{"URL":"http:\/\/encephalitisjournal.org\/journal\/view.php?doi=10.47936\/encephalitis.2025.00010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,10]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,7]]}},"URL":"https:\/\/doi.org\/10.47936\/encephalitis.2025.00010","relation":{},"ISSN":["2765-4559","2734-1461"],"issn-type":[{"value":"2765-4559","type":"print"},{"value":"2734-1461","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,10]]},"assertion":[{"value":"2025-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-28","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}