Persistent hiccups due to tuberculous meningitis in rural Tanzania – the value of Xpert testing in samples other than sputum

Abstract

Tuberculous meningitis is the most severe form of extra-pulmonary tuberculosis and it has been associated with high mortality and morbidity. Clinical presentation of tuberculous meningitis varies, and the microbiological confirmation is usually difficult. We present two cases presented with persistent hiccups, miliary tuberculosis and tuberculous meningitis proven by positive Xpert® MTB/RIF assay in the cerebral spinal fluid. The first case improved after two weeks of treatment and completed treatment as an outpatient. The second case was discharged after three weeks of treatment after his condition improved and we learned from the relatives he died two weeks later at home.