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WHAT IS IT?
Tuberculous meningitis is a type of meningitis that is caused by an infection of the central nervous system with Mycobacterium tuberculosis (TB).
WHY IS IT A PROBLEM?
If this infection has spread to the central nervous system then the patient is at a much higher risk for mortality/morbidity.
WHAT MAKES US SUSPECT IT?
Risk factors: known TB infection
Common symptoms (like other causes of meningitis) include: stiff neck, headache, fever, and vomiting .
Cranial nerve debts (ex cranial nerve III dysfunction) can be caused by tuberculous meningitis.
HOW DO WE CONFIRM A DIAGNOSIS?
PPD test will be positive in patients with any past infection with Mycobacterium tuberculosis
Lumbar puncture and subsequent CSF analysis often shows:
- Elevated protein
- Low glucose
- Increased lymphocytes
- Acid fast stain showing acid-fast bacilli (AFB) on smear/culture (culture takes a long time to come back and can be negative in many patients who are infected).
CT/MRI with contrast enhancement can show a tuberculoma in the brain or basil inflammation that is characterized by enhancement of th basal meninges after contrast infusion.
HOW DO WE RULE OTHER DIAGNOSES OUT?
HOW DO WE TREAT IT?
**TB is often resistant to multiple drugs**
Medications for treating: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
HOW WELL DO THE PATIENTS DO?
This is the most severe form of tuberculosis and has a high morbidity/mortality.
WAS THERE A WAY TO PREVENT IT?
Isoniazid is used as prophylaxis for infection with this pathogen.
WHAT ELSE ARE WE WORRIED ABOUT?
OTHER HY FACTS?
FURTHER READING
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Page Updated: 07.12.2016