Tuberculosis Meningitis in People Living with HIV/AIDS in a Health Center in the Brazilian Amazon: A Silent Disease

INTRODUCTION: Tuberculosis (TB) is one of the ten leading causes of death worldwide and the leading cause of infection in people living with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). It is a major public health problem in Brazil and worldwide. METHODS: This was a case series study of five meningeal tuberculosis and PLWHA coinfection patients admitted between June 2019 and June 2020, in a public hospital in the northern region of Brazil. Associated with clinical cases, we propose a discussion of the different laboratory diagnostic methods available in Brazil, with the aim of increasing the diagnosis of this very serious disease, with high mortality. RESULTS: The diagnosis of tuberculous meningitis is a challenge in clinical practice; thus, the clinical cases presented help the physician to recognize the signs and symptoms of the disease and improve the confirmatory diagnosis through acid-alcoholic resistant bacilli techniques, molecular testing, and mycobacteria culture in the cerebrospinal fluid. CONCLUSION: Knowing the diagnostic methods of tuberculous meningitis and its characteristics is of paramount importance to increase the correct diagnosis and reduce mortality in delayed treatment.