Objective:

To describe a rare case of concurrent tuberculous meningoencephalitis and autoimmune GFAP astrocytopathy, highlighting the clinical characteristics and treatment outcomes.

Approach:

• Case Presentation: A 67-year-old male presented with fever, cognitive slowing, and limb weakness. Diagnostic imaging, including MRI, and CSF analysis confirmed both conditions.

Key Findings:

• The patient exhibited symptoms consistent with both tuberculous meningoencephalitis and GFAP astrocytopathy.
• CSF analysis showed pleocytosis, increased protein, decreased glucose, and positive GFAP antibodies.
• The patient improved clinically with antitubercular drugs and corticosteroids, but imaging showed paradoxical worsening of lesions after steroid tapering.

Interpretation:

The coexistence of tuberculous meningoencephalitis and GFAP astrocytopathy is rare and can complicate diagnosis due to overlapping clinical features.

Limitations:

• The case study is based on a single patient, limiting generalizability.
• Further research is needed to understand the mechanisms and management of these concurrent conditions.

Conclusion:

Concurrent tuberculous meningoencephalitis and GFAP astrocytopathy require careful management of immunomodulatory therapy to avoid complications.