1.TUBERCULOUS MENINGITIS

TUBERCULOUS MENINGITIS

Overview and Facts

Tuberculosis (TB) is an infectious disease that affects the lungs of an afflicted individual. It is transmitted through the air. For example, when a person coughs and air droplets are inhaled by a healthy individual, this is called droplet transmission. This allows pathogens to enter the upper and lower respiratory tract of a healthy individual, ultimately causing infection, whether bacterial, viral, or fungal.

Mycobacterium tuberculosis is the pathogen responsible for tuberculosis. The bacteria could travel through the bloodstream and infect other organs and tissues, ultimately causing sepsis and multiple organ failure, if the infection is not treated early.

At times, the bacteria can spread to the meninges, which are sheaths that envelop the spinal cord and the brain. A life-threatening condition called meningeal meningitis could develop if the meninges are infected.

Types and Symptoms

Initially, the symptoms of tuberculous meningitis progress at a slow pace. They become more serious over time. In the initial phase of the infection, symptoms can include:

  • Fatigue
  • Malaise
  • Low-grade fever

Through the progression of the disease, its symptomatology will become more serious and concerning. Classical symptoms of meningitis such as light sensitivity, stiff neck, and headache will not be always present in tuberculous meningitis. However, you may experience the following symptoms:

  • Unconsciousness
  • Confusion
  • Irritability
  • Lethargy
  • Nausea and vomiting
  • Fever

Diagnosis & Medications

Your physician will perform a physical examination, ask you with regards to the symptoms that you exhibit, and ask about your medical history.

Your physician may request more laboratory tests if they suspect that you have symptoms of tuberculous meningitis.

Other laboratory tests your doctor might request to assess your current health condition may include:

  • Chest x-ray
  • Blood culture
  • Cranial CT scan
  • Skin test for tuberculosis (PPDskin test)
  • Meningeal biopsy

 

Complications

The complications of tuberculous meningitis are serious and could lead to life-threatening problems. It includes:

  • Brain damage
  • Hearing loss
  • Increased pressure in the brain
  • Seizures
  • Stroke
  • Death

Increased cranial pressure could lead to irreversible and permanent brain damage. Inform your physician immediately if you experience headaches and vision changes at the same time.

 

TREATMENT

Four drugs are traditionally prescribed to treat TB infection:

  • Isoniazid
  • Rifampin
  • Pyrazinamide
  • Ethambutol

Treatment of tuberculous meningitis includes these four medications, except for ethambutol. Ethambutol cannot readily penetrate the meninges. Respiratory fluoroquinolones such as moxifloxacin or levofloxacin are typically used instead of ethambutol.

Employing the use of systemic glucocorticoids are also recommended. Steroids can reduce complications associated with tuberculous meningitis.

Treatment may last for as long as 12 months as the pathogen needs a longer course of antibiotics for it to be eliminated. In some cases, you may need hospital treatment.

 

 

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