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Headache in a case of tuberculosis: think beyond meningitis-a case report

Sanchit Shailendra Chouksey1, Anand Vardhan Sharma2, Ekagrata Shukla3

  • 1Department of Neurology, Datta Meghe Medical College, DMIHER, Nagpur, Maharashtra, India.

Journal of Medical Case Reports
|April 16, 2026
PubMed
Abstract

Insights

Levofloxacin, an antibiotic for multidrug-resistant tuberculosis, can rarely cause intracranial hypertension. Stopping the drug led to symptom resolution in a teenage patient.

Area of Science:

  • Neurology
  • Pharmacology
  • Infectious Diseases

Background:

  • Intracranial hypertension (IIH) can be idiopathic or secondary to causes like tumors or medications.
  • Drug-induced intracranial hypertension is a recognized but less common etiology.

Purpose of the Study:

  • To report a rare case of levofloxacin-induced intracranial hypertension.
  • To highlight the importance of considering medication side effects in patients presenting with symptoms of raised intracranial pressure.

Main Methods:

  • A case presentation of a 14-year-old male treated for multidrug-resistant tuberculosis (MDR-TB).
  • The patient developed symptoms of increased intracranial pressure during levofloxacin therapy.
  • Diagnostic workup included fundoscopy, cerebrospinal fluid analysis, and magnetic resonance imaging (MRI).

Main Results:

  • The patient presented with headache and bilateral papilledema.
  • MRI revealed left transverse and sigmoid sinus stenosis.
  • Discontinuation of levofloxacin resulted in rapid symptom and sign resolution.

Conclusions:

  • Levofloxacin can be a potential cause of drug-induced intracranial hypertension.
  • Clinicians should maintain a high index of suspicion for this adverse effect in patients on levofloxacin therapy presenting with signs of raised intracranial pressure.
  • Prompt recognition and drug cessation are crucial for favorable outcomes.
Keywords:
HeadacheIntracranial hypertensionLevofloxacinPapilledema

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