Tuberculous Meningitis (TBM) is a form of meningitis characterized by inflammation of the membranes (meninges) around the brain or spinal cord and caused by a specific bacterium known as Mycobacterium tuberculosis. In TBM, the disorder develops gradually. Treatment with antibiotics and other drugs is usually effective against the infection.
Tuberculous Meningitis involves the central nervous system. Headaches and behavioral changes may be noticed initially. Fever, headache, a stiff neck, and vomiting may also occur. Symptoms among older children and adults may progress from irritability to confusion, drowsiness, and stupor, possibly leading to coma.
Untreated, this disorder can lead to seizures, hydrocephalus (accumulation of fluid in the brain cavity), deafness, mental retardation, paralysis of one side of the body (hemiparesis) and other neurological abnormalities. (For more information on this disorder, choose “hydrocephalus” as your search term in the Rare Disease Database).
Diagnosis is made by examination of the cerebrospinal fluid.
Tuberculous Meningitis is a rare complication that occurs in some patients who have or have had tuberculosis (TB), especially miliary tuberculosis. It can also occur in people who have been exposed to the bacteria that causes TB. This form of meningitis is caused by a specific bacteria known as Mycobacterium Tuberculosis. (For more information on tuberculosis, choose “tuberculosis” as your search term in the Rare Disease Database).
TBM is usually found in children aged one to five years although it may occur at any age.
Meningitis is usually treated with antibiotic drugs used against the bacteria causing the infection. These may include isoniazid, rifampin, streptomycin, and ethambutol. Treatment should last for at least 9 months to one year. Corticosteroid drugs such as prednisone may also be of benefit.
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TEXTBOOKS
Mayo Clinic Family Health Book, 2nd Ed.: David E. Larson, ed.-in-chief; William Morrow & Company, Inc., 1996. Pp. 481-82.
The Merck Manual, 17th Ed.: Mark H. Beers, M.D. and Robert Berkow, M.D., Eds. Merck Research Laboratories, 1999. P. 1202.
JOURNAL ARTICLES
A Diagnostic Rule for Tuberculous Meningitis. R. Kumar et al., Arch Dis Child (Sep 1999, 81 (3)). Pp. 221-24.
Tuberculosis of the Central Nervous System. R. K. Garg, Postgrad Med J. (Mar 1999, 75 (881)). Pp. 133-40.
Images in Clinical Medicine. Viallard J. F. et al., N Engl J Med. (Oct 1999, 341 (16)). P. 1197.
Radiological Case of the Month. Miliary Tuberculosis with Meningitis. G. A. Jackman, Arch Pediatr Adolesc Med. (Aug 1999, 153 (8)). Pp. 887-88.
Diagnosis of Tuberculous Meningitis by Detection of Antigen and Antibodies in CSF and Sera. K. L. Srivastava et al., Indian Pediatr. (Apr 1998, 35 (9)). Pp. 841-50.
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