on chest X-ray there are calcified lesions on hilar regions of both lungs; lesions that inalicates the presence of old heald granulomatous disease.The patient has immigrated from Afghanistan, where tuberculosis is a common problem of people, the patient has hyponatremia a finding more common in T.B. meningitis so another L.P was performed and CSF was sent for Stewart, PCR assay and culture for tuberculosis in the second CSF exam. The level of protein had increased (350 mg/dl) while CSF glucose decreased and a shifting CSF, PMN to lymphocyte were reported.Anti tuberculosis drugs were initiated (INH, RMP, PZP, ETB) and blood gasometric test, PPd and B.A. lavage for B.K performed, in the third hospital day, febrile agglutination tests, L.F.T, kidney function tests were performed and dark field illumination test of centrifuged CSF was done and it was negative. Cold agglutination assay and standard tube test for brucella, both of them were negative too. Headache in-patients thought to have tuberculosis should always raise the possibility of T.B meningitis. In the early stage of disease headache and fever may be the only symptoms. Analysis of CSF usually shows lymphocytic pleocytosis.Hypoglycorochia is present in approxinately 70% of cases. Smears of CSF are rarely positive in TB meningitis. CSF, PCR assay for BK was positive, but blood cultures sputum culture and CSF culture were all negative. After starting anti TB drugs additional treatment with dexamethasori and pyridoxine, the situation of patient gradually because better and after 4 weeks hospitalization he was discharged and ased him to come back to outpatient clinic for control of treatment of T.B.