A 27-year-old woman with a history of IVF-ET six months ago received 10 mg of prednisone per day for 20 days before embryo transfer. She suffered from spontaneous abortion one month ago and had a high fever immediately after the abortion. She was previously healthy and denied any previous history of TB and close family contacts. She was diagnosed with interstitial pneumonia and cured at a local hospital. Two weeks after the cure, she suddenly suffered from headaches, vomiting, and insanity. The signs of meningeal irritation were positive. In terms of auxiliary examination, CT showed no lung abnormalities, while brain MRI revealed multiple lesions (Figure 2A). The result of the HIV test was negative. The lumbar puncture showed an intracranial pressure of 110 mmH2O. Examination of CSF demonstrated a low level of glucose (40-50 mmol/L), pleocytosis (WBC was 22*10 9/L with 73% lymphocytes), and a high level of protein (121.2 mg/dl). Moreover, PPD-positive cells accounted for 26%, and ESAT-6 positive cells represented 25% of the CSF. No mycobacteria were found in the CSF by stained smear and culture. After 1 month of anti-tuberculous drugs (isoniazid, rifampicin, ethambutol, and pyrazinamide), levofloxacin, and some symptomatic treatment, the patient still had severe headaches and vomiting. Brain MRI showed no significant changes compared with the previous scan (Figure 2B). Intrathecal injections of isoniazid, dexamethasone, and chymotrypsin were performed to specifically prevent anti-TB and reduce arachnoid adhesion. Combined with the previous therapy for another month, her clinical symptoms were relieved. Moreover, the size and number of lesions were significantly reduced on brain MRI (Figure 2C).