MedlinePlus Medical Encyclopedia: Meningitis

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Meningitis - tuberculous

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Central nervous system

Alternative names Return to top

Tubercular meningitis, TB meningitis

Definition Return to top

Tuberculous meningitis is an infection of the meninges (membranes covering the brain and spinal cord) caused by the bacteria that causes tuberculosis, Mycobacterium tuberculosis.

Causes, incidence, and risk factors Return to top

Tuberculous meningitis is caused by spread of Mycobacterium tuberculosis from another site in the body. The onset of symptoms is usually gradual. Risk factors include a history of pulmonary tuberculosis, excessive alcohol use, AIDS, and/or other disorders that compromise the immune system.

Tuberculous meningitis is a very rare disorder.

Symptoms Return to top

Seizures
Fever
Listlessness
Loss of appetite
Severe headache
Nausea and vomiting
Stiff neck
Sensitivity to light (photophobia)
Loss of consciousness

Signs and tests Return to top

For any patient with meningitis, it is important to perform a lumbar puncture (spinal tap), where a needle is inserted into the back of the patient and spinal fluid (known as cerebrospinal fluid, or CSF) is sampled. The following tests help diagnose tuberculous meningitis:

Spinal fluid (CSF) stain positive for mycobacterium
CSF with high protein, low glucose and increased lymphocytes
CSF culture growing M. tuberculosis
CSF positive for M. tuberculosis PCR
Positive skin test for tuberculosis
Brain or meningeal biopsy showing M. tuberculosis

Treatment Return to top

Treatment involves use of antitubercular drugs as for pulmonary tuberculosis. Systemic steroids may also be used.

Expectations (prognosis) Return to top

Tuberculous meningitis is fatal if untreated. Long-term follow up is necessary to detect recurrences.

Complications Return to top

Residual brain damage may cause motor paralysis, convulsions, mental impairment, and abnormal behavior.

Calling your health care provider Return to top

Go to the emergency room or call the local emergency number (such as 911) if you suspect you or your child may have any form of meningitis. This condition can rapidly cause disability or death.

Call your health care provider if symptoms worsen or do not improve with treatment, or if new symptoms develop.

Prevention Return to top

In areas with high incidences of tuberculosis, the BCG vaccine may be helpful in preventing severe forms of tuberculosis, such as meningitis, in very young children. Otherwise, the spread of tuberculosis can be prevented by treating people who have evidence of a dormant tuberculosis infection, as evidenced by a positive PPD.

Update Date: 7/14/2004

Updated by: Daniel Levy, M.D., Ph.D., Infectious Diseases, Greater Baltimore Medical Center, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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