Case ReportsPulmonary Tuberculosis With Central Nervous System Streptococcus anginosus Coinfection in an Immunocompetent ManAta, Fateen MBBS∗; Sharma, Rohit MD∗; Ibrahim, Wanis Hamad FRCP∗,†; Kartha, Anand Bhaskaran MD, MS∗Author Information From the Departments of ∗Medicine †Pulmonology, Hamad Medical Corporation, Doha, Qatar. Correspondence to: Fateen Ata, MBBS, Department of Internal Medicine, Hamad General Hospital, Doha, Qatar, PO BOX 3050. E-mail: [email protected]. ORCID ID: https://orcid.org/0000-0001-7121-8574 The authors have no conflicts of interest to disclose. This work was supported by the Qatar National Library. Written informed consent was taken from the patient before the submission of the article. F.A. wrote the manuscript, obtained informed consent, did the literature review, obtained images, and reviewed and approved the final manuscript. R.S. wrote the manuscript, obtained informed consent, did literature review, and reviewed and approved the final manuscript. W.H.I. did the literature review, critical review of manuscript, and revisions in manuscript, and reviewed and approved the final manuscript. A.B.K. determined eligibility, did the case identification, literature review, critical review of manuscript, and revisions in manuscript, and reviewed and approved the final manuscript. Infectious Diseases in Clinical Practice: July 2021 - Volume 29 - Issue 4 - p e250-e253 doi: 10.1097/IPC.0000000000000961 Buy Metrics Abstract Tuberculosis (TB) is a ubiquitous disease occurring in every part of the globe. The central nervous system (CNS) involvement of TB has been a well-known complication with significant morbidity. Knowledge about TB and CNS bacterial coinfection is limited. We present a case of pulmonary TB and Streptococcus anginosus (SA) brain abscess in an immunocompetent middle-aged patient. This case presented with left upper and lower limb weakness and was found to have right-sided subdural empyema due to SA along with pulmonary TB. In cases of suspected CNS-TB, which develop neurological deterioration despite adequate treatment, an alternative microbiological diagnosis should be kept in the differentials. The CNS bacterial infections from the SA group occurring in concurrence with pulmonary TB can lead to severe complications. Timely neurosurgical intervention may be needed in such instances. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.