Simultaneous tubercular meningitis and ethmoidal sinus tuberculoma mimicking as Foster Kennedy syndrome

A 35-year-old male presented with gradual-onset progressive loss of vision in the left eye of 2 months duration. There was history of fever, weight loss, and headache. Comprehensive ocular examination revealed disc edema in the right eye and optic atrophy in the left eye. Further radiologic, histopathologic, and cerebrospinal fluid study led to a diagnosis of tubercular meningitis and ethmoidal sinus tuberculoma compressing the left optic nerve. The clinical picture mimicked Foster Kennedy syndrome. This case highlights the importance of ancillary investigations in the form of radiologic and histopathologic studies in arriving at the final correct diagnosis.