Meningitis - tuberculous

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Central nervous system

Tubercular meningitis; TB meningitis

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

For any patient with meningitis, it is important to perform a lumbar puncture (spinal tap), where doctors take a sample of spinal fluid (known as cerebrospinal fluid, or CSF) and send it for lab tests. The following tests help diagnose tuberculous meningitis:

• CSF stain positive for mycobacterium
• CSF with high level of protein, low glucose (sugar) level, and increased number of lymphocytes
• CSF culture growing M. tuberculosis
• Polymerase chain reaction (PCR) shows CSF positive for M. tuberculosis
• Positive skin test for tuberculosis (PPD)
• Brain or meningeal biopsy showing M. tuberculosis

Review Date: 09/06/2006
Reviewed By: Hilary M. Babcock, M.D., Medical Director of Occupational Infection Control, Barnes-Jewish and St. Louis Children's Hospitals; Instructor of Medicine, Infectious Disease Division, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.