Although early and rapid identification of TBM is crucial for successful disease management, in most of the cases, diagnosis is significantly delayed. Initial signs and symptoms of disease are non-specific and the suspicion of TBM usually arises only some days or weeks after the disease’s onset and is not different in children who have or have not been vaccinated with Bacille Calmette-Guerin.6 Fever, headache, anorexia, and vomiting characterize the prodrome of disease in older children, whereas failure to thrive, poor appetite, vomiting, and sleep disturbances are more common in younger ones.7 TBM is more easily suspected when these symptoms are associated with a history of recent contact with a case of documented TB or when, after the first days of disease, relevant neurological manifestations, such as cranial nerve palsy,occur.