Figure 2: Post contrast MRI coronal section showing diffuse leptomeningeal enhancement in bilateral cerebral hemispheres with multiple enhancing nodular lesions in bilateral cerebral hemispheres, basal ganglia and brainstem.
Along with the continuation of antitubercular therapy, the patient was started on dexamethasone 4mg TDS for four weeks, which was tapered off and stopped. During her hospital stay, she developed ATT-induced hepatitis, for which she was kept in liver friendly regimen until recovery. She was reinitiated on ATT after improvement in liver function. The patient had developed pneumoperitoneum with pneumomediastinum, which was managed conservatively.
At the time of discharge, she could walk without support and was oriented to time place and person. Two weeks later, she presented with fever and burning micturition, which was treated with appropriate antibiotics. Her SARS COV-2 report was positive despite being previously vaccinated with two doses of Vero cell vaccine. She was admitted to the COVID-19 isolation ward, where her stay was uneventful. On the follow-up visit, patient was doing fine and was taking intensive phase of ATT drugs. Her steroid dosage was gradually tapered on follow up visit.