Tuberculous meningitis and hemophagocytic lymphohistiocytosis in a patient on adalimumab: diagnostic challenges in the setting of suspected non-tuberculous mycobacteria co-infection

The increased risk of opportunistic infections associated with long-term tumour necrosis factor-alpha inhibitor use necessitates ongoing infection screening.Hemophagocytic lymphohistiocytosis triggered by mycobacterial infections requires prompt recognition and targeted treatment.Polymerase chain reaction results should be interpreted with caution in complex clinical scenarios, as deoxyribonucleic acid detection may indicate colonization rather than active infection.