Starry Sky In Disseminated Tuberculosis

A 31 years-old male had fever, cough, and lymphadenopathy 11 months ago. He had close contact with his uncle, who had pulmonary tuberculosis. His investigations, including bronchoalveolar lavage and lymph node biopsy, were inconclusive for tuberculosis and sarcoidosis. He was prescribed prednisolone 40 mg with an empirical diagnosis of sarcoidosis. His fever and cough subsided after 1 month, and lymphadenopathy disappeared after 3 months. Prednisolone was stopped after 4 months. Nine months later, he was readmitted with 2 weeks history of headache, seizure, left-sided weakness and altered sensorium.