Immunology/Microbiology for IDIntrathecal Hyaluronidase in Tubercular Arachnoiditis The Unexplored AdjuvantSamal, Priyanka MD, DM∗; Elavarasi, Arunmozhimaran MD, DM∗; Kumar, Anand MD, DM∗; Prabhakar, Anuj MD, DM†; Vishnu, Venugopalan Y. MD, DM∗; Singh, Mamta B. MD, DM∗; Srivastava, M. V. Padma MD, DM∗; Goyal, Vinay MD, DM∗Author Information From the Departments of ∗Neurology †Neuroradiology, All India Institute of Medical Sciences, New Delhi, India. Correspondence to: Vinay Goyal, MD, DM, FIAN, Department of Neurology, AIIMS, New Delhi 110029. E-mail: email@example.com. The authors have no funding or conflicts of interest to disclose. Infectious Diseases in Clinical Practice: July 2020 - Volume 28 - Issue 4 - p 230-233 doi: 10.1097/IPC.0000000000000883 Buy Metrics Abstract Intrathecal hyaluronidase for short duration as an adjuvant for treatment of tubercular arachnoiditis was tried in the past, and although the initial results were promising, surprisingly, no further confirmatory studies were undertaken and have not come into routine clinical use. We did a retrospective chart review of 25 patients who had tubercular meningitis with spinal or opticochiasmatic arachnoiditis who were given weekly intrathecal hyaluronidase for 10 weeks, in addition to antitubercular drugs and steroids. Of the 19 patients with spinal tubercular arachnoiditis, 10 were independent by the time of completion of therapy. All patients with opticochiasmatic arachnoiditis showed some improvement in vision. This promising retrospective study highlights the utility of hyaluronidase in tubercular meningitis with arachnoiditis and need of prospective randomized control trial. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.