Tubercular Dactylitis in a Young Boy

A 9-year-old, fully immunized boy presented with a 2-month history of intermittent, low-grade fever followed by frontotemporal headache, vomiting, bilateral squint, drooping of the right eyelid, and double vision for the past 2 days. There were no seizures, altered sensorium, or behavioral changes. His mother had been treated for pulmonary tuberculosis 7 years previously. Examination showed pallor, cervical lymphadenopathy, bilateral papilledema, right-sided 3rd and 6th nerve palsies, meningismus, brisk muscle stretch reflexes, and bilateral Babinski sign.

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