MRCP2-3445

MRCP2-3445

A 32-year-old woman is brought to the Emergency Department after being found wandering aimlessly on the street. She has a history of drug abuse and has been living in a shelter. The shelter staff report that she has been coughing and losing weight for several months. On admission, she is disoriented and lethargic. Further tests reveal the following results:

Cerebral spinal fluid (CSF) cells Lymphocytic picture with 800 cells/cm per mm cubed < 5/mm3
CSF glucose 2.0 mmol/l 2.5–3.9 mmol/l
CSF protein 2.0 g/l < 0.45 g/l
Blood glucose 6.0 mmol/l 3.5–5.5 mmol/l
CT scan Obstructive hydrocephalus

What is the most likely diagnosis for this patient?