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Challenges in Tuberculous Meningitis

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Meningitis and Encephalitis

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Abstract

Ten million cases of tuberculosis occur annually in the world, and the second most frequent extrapulmonary manifestation is meningitis. Tuberculous meningitis is notoriously difficult to diagnose as the disease initially resembles many common and nonsevere illnesses, and detection of the organism is difficult, especially in young children who are particularly prone to developing the disease. The clinical manifestations closely follow the pathophysiology, much of which is determined by the host response to the organisms. Treatment requires the use of several drugs for many months and is often complicated by immune reconstitution inflammatory syndrome. All of these problems are enhanced in patients with HIV coinfection, who also may be affected by other unusual pathogens that cause similar clinical manifestations. Neuroradiology is critically important for the early and accurate diagnosis of tuberculous meningitis. While treatment has concentrated on killing the organism, there is renewed emphasis on determining how to best control the deleterious effects of the inflammation that accompanies the infection.

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Authors and Affiliations

  1. Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, USA

    Jeffrey R. Starke & Andrea T. Cruz

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  1. Jeffrey R. Starke
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  2. Andrea T. Cruz
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Correspondence to Jeffrey R. Starke .

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  1. UT Health-McGovern Medical School, Houston, Texas, USA

    Rodrigo Hasbun

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Starke, J.R., Cruz, A.T. (2018). Challenges in Tuberculous Meningitis. In: Hasbun, R. (eds) Meningitis and Encephalitis. Springer, Cham. https://doi.org/10.1007/978-3-319-92678-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-92678-0_6

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