Tubercular meningitis; TB meningitis

The symptoms usually begin gradually, and may include:

• Fever and chills
• Mental status changes
• Nausea and vomiting
• Sensitivity to light (photophobia)
• Severe headache
• Stiff neck (meningismus)

Other symptoms that can occur with this disease:

• Agitation
• Bulging fontanelles
• Decreased consciousness
• Poor feeding or irritability in children
• Unusual posture, with the head and neck arched backwards (opisthotonos)

Physical examination will usually show:

• Fast heart rate
• Fever
• Mental status changes
• Stiff neck

For any patient who is suspected of having meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which spinal fluid (known as cerebrospinal fluid, or CSF) is collected for testing. When the health care provider suspects tuberculous meningitis, more than one CSF sample may be needed to make the diagnosis.

Tests that may be done include:

• Biopsy of the brain or meninges
• Blood culture
• Chest x-ray
• CSF examination for cell count, glucose, and protein
• CT scan of the head
• Gram stain, other special stains, and culture of CSF
• Polymerase chain reaction (PCR) of CSF
• Skin test for tuberculosis (PPD)

Images

Central nervous system

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Meningitis Overview

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Meningitis Treatment

Review Date: 09/15/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, University of Washington School of Medicine; and Jatin M. Vyas, PhD, MD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)