Introduction: Tuberculosis remains a major public health problem. The damage\nto the central nervous system is severe. We reported here two cases.\nClinical Case 1: A 37-year-old female patient, naively Human Immunodeficiency\nVirus1 (HIV1)-positive with antiretroviral (ARV) treatment, hospitalized\nin the Internal Medicine department for altered consciousness in a febrile\ncontext. The clinical examination at admission noted a meningeal syndrome.\nCytological analysis of the cerebrospinal fluid (CSF) revealed lymphocytic\nmeningitis with 98% lymphocytes for 3634 leukocytes. CSF polymerase\nchain reaction (PCR) detected Mycobacterium tuberculosis DNA. She\nwas put on anti-tuberculosis treatment. The immediate course was favourable,\nbut a secondary worsening of the clinical picture was the cause of his\ndeath. Clinical Case 2: A 34-year-old male patient, naively HIV1-positive\nwith ARV treatment. He is hospitalized in the Multi-Purpose Anaesthesia and\nResuscitation Department of the CNHU HKM for altered consciousness in a\nfeverish context. The clinical examination noted a meningeal syndrome. The\ncytological analysis of the CSF noted 184 leukocytes for 99% lymphocytes.\nThe CSF PCR identified the DNA of Mycobacterium tuberculosis . He was put\non anti-tuberculosis treatment. The evolution was marked by his death.\nConclusion: The neuromeningeal localization of tuberculosis is a poor prognosis.\nCo-infection with HIV remains a potential deadly combination.
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