Neurological TB in HIV

  • Louise Bovijn
  • Regan Solomons
  • Suzaan Marais


Central nervous system (CNS) tuberculosis (TB) is the worst form of TB and may present as (1) intracranial pathology, including tuberculous meningitis (TBM), tuberculoma/abscess, and rarely cerebritis or encephalopathy (described in children) and, (2) intraspinal disease. HIV co-infection increases the risk of developing CNS TB substantially, especially in patients with severe immunosuppression (CD4 count <100 cells/μL). In this chapter, we discuss the pathogenesis, clinical and imaging findings, management and outcomes of the most frequent forms of CNS TB in HIV co-infected patients. We further review the features and management of a frequently fatal complication related to starting antiretroviral therapy (ART), namely neurological TB immune reconstitution inflammatory syndrome (IRIS).


Tuberculous meningitis TB radiculomyelitis Tuberculoma Spinal TB Extra-pulmonary TB Central nervous system 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Louise Bovijn
    • 1
  • Regan Solomons
    • 2
  • Suzaan Marais
    • 3
    • 4
  1. 1.Neurosciences DepartmentJohn Radcliffe HospitalOxfordUK
  2. 2.Department of Paediatrics and Child HealthStellenbosch UniversityCape TownSouth Africa
  3. 3.Department of NeurologyInkosi Albert Luthuli Central HospitalDurbanSouth Africa
  4. 4.Department of MedicineUniversity of KwaZulu-NatalDurbanSouth Africa

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