Tuberculosis Meningitis Flashcards
Is it acute or chronic
Chronic
Causitive organism
Mycobacterium tuberculosis
Mycobacterium bovis
Meningitis from primary pulmonary tuberculosis is by
Bacteraemia
Metastatic foci after bacteraemia is
Meninges
Cerebral or spinal tissue
Choroid plexus
The infection (M.tuberculosis) spreads from the metastaic foci by _______ into _______________
Rupture into subarachnoid space
Reactivation of metastatic foci occurs
Spontaneous or by
Impaired immunity
Immunity impairment can be cause by
Measles infection
Alcohol use
Steroid use
AIDS etc
Clinical features of TB meningitis is caused by
Infection
Exudation
Vasculitis
Hydrocephalus in TB meningitis is due to
Obstruction of basal cisterns by exudation
Infarction in brain after tb meningitis is caused due to
Vasculitis
Clinical features stages in TB meningitis
Stage 1(early)
Stage 2(intermediate)
Stage 3(advanced)
Stage 1 clinical features
Non specific symptoms :
Fever
Lethargy
Stage 2 clinical features
Confusion
Cranial nerve paresis
Meningism
Vasculitis
Stage 3 clinical features
Coma
Why is staging important in TB meningitis
To predict the outcome of
Will there be seizures in Tb meningitis
Yes maybe
Atypical tb meningitis presentation
Dementia (slow progressing)
Or fast like pyogenic meningitis
Diagnosis
Lymphocytosis
Anaemia
PCR
Tuberculin skin test
Chest x ray
Ct scan and mri
Will there be change in ADH secretion in TB meningitis
ADH secretion will be reduced due to hypothalamus damage or infarction
Treatment
Isoniazid
Rifampicin
Pyrazinamide
In drug resistance tb meningitis we give
Streptomycin
Or
Ethambutol
Drugs that penetrate meninges well are
Isoniazid and
Pyrazinamide
