Tuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges).
Tubercular meningitis; TB meningitis
Causes, incidence, and risk factors
Tuberculous meningitis is caused by Mycobacterium tuberculosis, the bacteria that cause tuberculosis. The bacteria spread to the brain and spine from another site in the body.
Risk factors include a history of:
Weakened immune system
Tuberculous meningitis is a very rare disorder in the U.S.
The symptoms usually begin gradually, and may include:
- Fever and chills
Mental status changes
- Nausea and vomiting
- Sensitivity to light (
- Severe headache
- Stiff neck (meningismus)
Other symptoms that can occur with this disease:
Bulging fontanellesin babies
Poor feeding or irritability in children
Unusual posture, with the head and neck arched backwards (
Signs and tests
The doctor or nurse will examine you. This will usually show:
Fast heart rate
Mental status changes
A lumbar puncture (“
Other tests that may be done include:
Biopsyof the brain or meninges
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 (
- Other tests to look for tuberculosis
You will be given several medicines to fight the tuberculosis bacteria. Sometimes, treatment is started even if your doctor thinks you have the disease, but testing hasn’t confirmed it yet.
Treatment usually lasts for at least 12 months.
Tuberculous meningitis is life threatening if untreated. Long-term follow-up is needed to detect repeated infections (recurrences).
Build-up of fluid between the skull and brain (
Calling your health care provider
Call the local emergency number (such as 911) or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
Persistent unexplained fever
Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.
The BCG vaccine may help prevent severe forms of tuberculosis, such as meningitis, in very young children who live in areas where the disease is common.
Treating people who have signs of a non-active (dormant) tuberculosis infection can prevent the spread of tuberculosis. A PPD test and other tuberculosis tests can be done to tell if you have this type of infection.