Introduction: Neuromeningeal tuberculosis of deleterious, paradoxical, progression despite appropriate antibiotic therapy is rare. Observation: An immunocompetent patient with tuberculous meningitis. The paradoxical evolution under well - conducted bacillary treatment associated with corticosteroid therapy was marked by the appearance of multiple cerebral abscesses in different topography. Discussion: During anti-tuberculosis therapy clinical worsening is rare, particularly when it occurs in an immunocompetent patient. This possibility should be systematically evoked in such cases. The explanation of this phenomenon is still unclear.