Pulmonary Tuberculosis With Central Nervous System Streptococcus anginosus Coinfection in an Immunocompetent Man

Tuberculosis (TB) is a ubiquitous disease occurring in every part of the globe. The central nervous system (CNS) involvement of TB has been a well-known complication with significant morbidity. Knowledge about TB and CNS bacterial coinfection is limited. We present a case of pulmonary TB and Streptococcus anginosus (SA) brain abscess in an immunocompetent middle-aged patient. This case presented with left upper and lower limb weakness and was found to have right-sided subdural empyema due to SA along with pulmonary TB. In cases of suspected CNS-TB, which develop neurological deterioration despite adequate treatment, an alternative microbiological diagnosis should be kept in the differentials. The CNS bacterial infections from the SA group occurring in concurrence with pulmonary TB can lead to severe complications. Timely neurosurgical intervention may be needed in such instances.