Tuberculous Meningitis With Persistent Hiccups: A Case Report.

A 69-year-old Japanese male presented with atypical symptoms of tuberculous meningitis (TBM), including intermittent left temporal headache and persistent hiccups that were unresponsive to initial therapies. Despite comprehensive imaging, no definitive intracranial lesions were identified. His persistent hiccups, along with typical meningitis symptoms, highlighted the diagnostic challenges of TBM, particularly in the context of negative microbiological tests. Early empirical treatment, initiated based on clinical suspicion and elevated cerebrospinal fluid (CSF) adenosine deaminase levels, led to clinical improvement and supported a diagnosis of TBM. This case underscores the importance of considering TBM in patients with unusual symptoms, such as persistent hiccups, to prevent delays in diagnosis and treatment.