Surreal digital illustration symbolizing the convergence of HIV/AIDS, tuberculosis meningitis, and stridor.

Unmasking Meningitis and Stridor: A Deep Dive into Advanced Immune Deficiency Syndromes

Avery Sinclair in Health & Wellness November 2025 • 5 min read.

"Navigating the complexities of HIV/AIDS: Understanding the rare intersection of tuberculosis meningitis and stridor, and its impact on vulnerable populations."

In the intricate world of infectious diseases, certain conditions present diagnostic and therapeutic challenges that demand a thorough understanding of underlying mechanisms and innovative approaches to patient care. One such complexity arises in individuals with advanced Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS), where the convergence of multiple infections can lead to rare and life-threatening complications. This article explores a unique and challenging case involving the coexistence of tuberculosis meningitis and stridor in an adult patient with advanced HIV/AIDS, shedding light on the diagnostic complexities, potential etiologies, and management strategies for such rare scenarios.

HIV/AIDS weakens the immune system, making individuals susceptible to a variety of opportunistic infections. Tuberculosis (TB), caused by the bacterium Mycobacterium tuberculosis, is a leading cause of mortality among people living with HIV/AIDS. When TB affects the central nervous system, it can result in tuberculosis meningitis, a severe and potentially fatal infection characterized by inflammation of the meninges, the membranes surrounding the brain and spinal cord.

Stridor, characterized by high-pitched, wheezing sound during breathing, indicates an obstruction in the upper airway. While stridor can arise from various causes, including foreign objects, infections, or structural abnormalities, its occurrence in the setting of tuberculosis meningitis raises concerns about potential complications such as mediastinal masses or central nervous system involvement. The convergence of these conditions presents a complex diagnostic and management challenge, requiring a multidisciplinary approach to ensure timely and effective patient care.

Case Report: A Rare Convergence

Surreal digital illustration symbolizing the convergence of HIV/AIDS, tuberculosis meningitis, and stridor.

In a medical case that underscores the complexities of advanced immune deficiency syndromes, a 37-year-old female with a history of retroviral disease was admitted to the hospital due to confusion. Prior to her admission, she had been experiencing severe headaches for three weeks. Her medical history revealed that she had started antiretroviral drugs two months earlier but had since defaulted on her treatment. Initial clinical examination revealed that the patient was confused, febrile, and pale. She had a normal blood pressure reading but was experiencing tachycardia. Cardiac examination was unremarkable. She was tachypneic with crackles throughout both lung fields. Neurological examination identified neck stiffness without localizing signs.

Several diagnostic tests were conducted, including blood tests, microbiology, lumbar puncture analysis, and a chest film. Blood tests revealed normocytic normochromic anemia, hyponatremia, and a slightly raised alanine transaminase. Her viral load was elevated, and her CD4 count was low. Cerebrospinal fluid analysis showed an increase in lymphocytes, a raised protein level, and decreased glucose. India ink staining and a Cryptococcus latex antigen test were both negative. Sputum analysis and blood cultures were negative for Mycobacteria. The anterior-posterior supine chest film showed bilateral nodular infiltrates with hilar and mediastinal lymphadenopathy.

Given the complexity of the case, several potential causes of the patient's stridor were considered:

Mediastinal mass
Central mechanism secondary to tuberculosis meningitis
Direct laryngeal involvement
Raised intracranial pressure

Despite these limitations, this case is unique because it reports the presence of both stridor and tuberculosis meningitis in an adult patient. The case underscores the importance of considering rare manifestations of common diseases, particularly in immunocompromised individuals. The patient's condition deteriorated despite medical intervention, highlighting the challenges in managing advanced HIV/AIDS with multiple opportunistic infections. The lack of definitive imaging and autopsy limited the ability to fully elucidate the underlying causes of the patient's stridor and subsequent complications. Further research is needed to better understand the pathogenesis of stridor in the setting of tuberculosis meningitis and to develop more effective diagnostic and treatment strategies.

Conclusion: Implications for Future Research and Patient Care

The rare convergence of tuberculosis meningitis and stridor in a patient with advanced HIV/AIDS underscores the complexity of managing opportunistic infections in immunocompromised individuals. The diagnostic and therapeutic challenges highlighted in this case underscore the need for further research to better understand the underlying mechanisms and improve patient outcomes. By sharing such experiences, medical professionals can enhance their ability to recognize and respond to rare manifestations of common diseases, ultimately leading to improved care for vulnerable populations.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.2147/ijgm.s46734, Alternate LINK

Title: Meningitis And Stridor In Advanced Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

Subject: General Medicine

Journal: International Journal of General Medicine

Publisher: Informa UK Limited

Authors: Poobalan Naidoo, Saman, Diana Pillay

Published: 2013-09-01

Everything You Need To Know

How does tuberculosis meningitis specifically affect individuals with advanced HIV/AIDS, according to the text?

Tuberculosis meningitis occurs when Mycobacterium tuberculosis infects the meninges, the membranes surrounding the brain and spinal cord, causing inflammation. In individuals with advanced HIV/AIDS, the weakened immune system makes them highly susceptible to this severe infection. The case highlights the importance of considering tuberculosis meningitis in immunocompromised patients presenting with neurological symptoms.

What is stridor, and what concerns does it raise when it occurs in conjunction with tuberculosis meningitis as noted?

Stridor, characterized by a high-pitched, wheezing sound during breathing, indicates an obstruction in the upper airway. In the context of tuberculosis meningitis, stridor raises concerns about potential complications such as mediastinal masses or central nervous system involvement. The convergence of these conditions presents a complex diagnostic and management challenge.

What possible causes of stridor were considered in the reported case, and what limited the ability to confirm the exact cause?

The text outlines several potential causes of stridor in the described case, including: Mediastinal mass, Central mechanism secondary to tuberculosis meningitis, Direct laryngeal involvement, and Raised intracranial pressure. However, without definitive imaging or autopsy, determining the precise cause of stridor remains challenging, underscoring the diagnostic complexities in such cases.

What kind of approach is needed when HIV/AIDS patients have tuberculosis meningitis and stridor and why is it difficult to treat?

The convergence of tuberculosis meningitis and stridor in individuals with advanced HIV/AIDS necessitates a multidisciplinary approach involving infectious disease specialists, neurologists, pulmonologists, and radiologists. Timely diagnosis requires a combination of clinical evaluation, imaging studies, and laboratory tests, while management involves prompt initiation of appropriate antimicrobial therapy, airway management, and supportive care. However, challenges in diagnosis and treatment underscore the need for further research to improve patient outcomes.

What are the broader implications for future research and patient care that arise from this rare convergence of tuberculosis meningitis and stridor?

The case underscores the critical need for further research to elucidate the underlying mechanisms driving the convergence of tuberculosis meningitis and stridor in immunocompromised individuals. Understanding the pathogenesis of these conditions can inform the development of more effective diagnostic and therapeutic strategies. Additionally, sharing similar experiences among medical professionals can enhance their ability to recognize and respond to rare manifestations of common diseases, ultimately improving care for vulnerable populations.