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Propionibacterium acnes is thought to be a potential triggering agent of sarcoidosis. We describe a woman who developed chronic meningitis with sarcoid-like multisystemic involvement under treatment for human immunodeficiency virus infection. P. acnes was isolated from cerebrospinal fluid. We assume that P. acnes might have triggered this sarcoid-like reaction with meningitis, as a consequence of an immune reconstitution.