A tuberculous meningitis occurred in a 34 years old HIV infected intra
venous drug abuser patient. The diagnosis was evoked despite an unusua
l cerebrospinal fluid cytology and the absence of extra meningeal sign
s of tuberculosis or acid-fast bacilli on direct examination. It was l
ater confirmed by a positive CSF culture. Apyrexia was obtained with c
iprofloxacin, then with a classical antituberculosis therapy. The outc
ome was favourable, with more than 8 months follow-up.