Tuberculous meningitis in patients with nasopharyngeal carcinoma

Mycobacterial infection has been recognized as a complication in patients with malignancy. Tuberculous (TB) meningitis has not been reported in patients with nasopharyngeal carcinoma (NPC); it may have been overlooked or confused with the underlying malignancy or meningitis caused by other microorganisms. We describe the occurrence of culture-proven TB meningitis in 2 NPC patients. The time lag between the diagnosis of NPC and the occurrence of TB meningitis was 4 years in 1 patient and 6 years in the other. In both patients, the diagnosis of TB meningitis was delayed; they were initially treated for bacterial meningitis. Subsequent antituberculous chemotherapy was successful in 1 patient but failed in the other. Recognition of the infection is important for early diagnosis and proper treatment of this potentially fatal condition in patients with NPC.