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About tuberculous meningitis

What is tuberculous meningitis?

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.

What are the symptoms for tuberculous meningitis?

At first, symptoms of TB meningitis typically appear slowly. They become more severe over a period of weeks. During the early stages of the infection, symptoms can include:

  • fatigue
  • malaise
  • low-grade fever

As the disease progresses, the symptoms will become more serious. Classic symptoms of meningitis, such as stiff neck, headache, and light sensitivity, are not always present in meningeal tuberculosis. Instead, you may experience the following symptoms:

  • fever
  • confusion
  • Nausea and vomiting
  • lethargy
  • irritability
  • unconsciousness

What are the causes for tuberculous meningitis?

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. 

What are the treatments for tuberculous meningitis?

Four drugs are typically used to treat TB infection:

  • isoniazid
  • rifampin
  • pyrazinamide
  • ethambutol

TB meningitis treatment includes these same medications, except for ethambutol. Ethambutol does not penetrate well through the lining of the brain. A fluoroquinolone, such as moxifloxacin or levofloxacin, is typically used in its place.

Your doctor may also prescribe systemic steroids. Steroids will reduce complications associated with the condition.

Depending on the severity of the infection, treatment may last as long as 12 months. In some cases, you may need treatment in the hospital.

What are the risk factors for tuberculous meningitis?

TB and TB meningitis can develop in children and adults of all ages. However, people with specific health problems are at greater risk of developing these conditions.

Risk factors for TB meningitis include having a history of:

  • excessive alcohol use
  • weakened immune system
  • diabetes mellitus

TB meningitis is rarely found in the United States because of high vaccination rates. In low-income countries, children between birth and 4 years of age are most likely to develop this condition.

Is there a cure/medications for tuberculous meningitis?

Your outlook will depend on the severity of your symptoms and how quickly you seek treatment. An early diagnosis allows your doctor to provide treatment. If you receive treatment before complications develop, the outlook is good.

The outlook for people who develop brain damage or stroke with TB meningitis is not as good. Increased pressure in the brain strongly indicates a poor outlook for a person. Brain damage from this condition is permanent and will impact health over the long term.

You can develop this infection more than once. Your doctor will need to monitor you after you’re treated for TB meningitis so they can detect a new infection as early as possible.

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