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Tuberculous Meningitis : Diagnosis and Treatment Overview
Joint Authors
Source
Tuberculosis Research and Treatment
Issue
Vol. 2011, Issue 2011 (31 Dec. 2011), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2011-12-21
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality.
TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis.
Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose.
CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples.
Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test.
Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies.
Empiric treatment should include at least four first-line drugs, preferably isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol; the role of fluoroquinolones remains to be determined.
Adjunctive treatment with corticosteroids has been shown to improve mortality with TBM.
In HIV-positive individuals with TBM, important treatment considerations include drug interactions, development of immune reconstitution inflammatory syndrome, unclear benefit of adjunctive corticosteroids, and higher rates of drug-resistant TB.
Testing the efficacy of second-line and new anti-TB drugs in animal models of experimental TBM is needed to help determine the optimal regimen for drug-resistant TB.
American Psychological Association (APA)
Marx, Grace E.& Chan, Edward D.. 2011. Tuberculous Meningitis : Diagnosis and Treatment Overview. Tuberculosis Research and Treatment،Vol. 2011, no. 2011, pp.1-9.
https://search.emarefa.net/detail/BIM-499066
Modern Language Association (MLA)
Marx, Grace E.& Chan, Edward D.. Tuberculous Meningitis : Diagnosis and Treatment Overview. Tuberculosis Research and Treatment No. 2011 (2011), pp.1-9.
https://search.emarefa.net/detail/BIM-499066
American Medical Association (AMA)
Marx, Grace E.& Chan, Edward D.. Tuberculous Meningitis : Diagnosis and Treatment Overview. Tuberculosis Research and Treatment. 2011. Vol. 2011, no. 2011, pp.1-9.
https://search.emarefa.net/detail/BIM-499066
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-499066