A 24 year old G2A1 with MCDA Twins at 35 weeks underwent Emergency LSCS for fetal distress under spinal anaesthesia . On 5th postoperative day she had thrown one episode of GTCS and was diagnosed as Postpartum eclampsia and treated with Magnesium sulphate .She developed high fever spikes the next day and deasaturated .She was diagnosed to have PPCM with LVEF of 40 % .She was treated with cardiotonics and braodspectrum antibiotics and ventilated for 2 days. Abdominal USG revealed mild hepatospleenomegaly with normal puerperal uterus without any free fluid. . Her cervical swab grown E.Coli and Klebsiella and was treated with Magnex and Amikacin. Her chest X-ray was suggestive of pulmonary edema .CT brain showed features of PRESS and GCS was E1V1M 4. MRI was undertaken which was reported as patchy meningeal thickening with distended transverse venous sinus .Her fever spikes did not respond to higher specific antibiotics and was planned to start empirical ATT . DTCD opinion was taken to institute ATT and her MRI review revealed focal meningeal thickening and findings were consistent with meningeal tuberculosis and hence she was started on ATT .Her fever subsided within 48 hrs. A lumbar puncture was undertaken as per the advice of Neurologist and CSF was subjected to TB PCR which was negative. She was continued on ATT under DOTS and was discharged after a month in good health and was adviced to continue Category I ATT from a nearby center