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Tuberculosis of the Central Nervous System

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Tuberculosis in Clinical Practice
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Abstract

Tuberculosis (TB) affecting the central nervous system (CNS) accounts for 1% of presentations and can either manifest as a subacute lymphocytic meningitis or with neurological deficit relating to space-occupying tuberculoma. Of all the forms of TB it has the most unfavourable outcome especially when patients present with a reduced conscious level. Due to its paucibacillary nature CNS TB is difficult to diagnose though the recent development of Xpert MTB/RIF Ultra promises a rapid diagnostic with high sensitivity. It is important to ensure a large volume of CSF (8–10 mL) is taken to improve the likelihood of a microbiological diagnosis. For treatment, the CSF penetration of drugs is important to consider, however, the recommended first-line regimen for drug sensitive CNS disease is typically the same as for other forms of TB though for 12 rather than 6 months. Adjunctive therapy with Dexamethasone has been shown to reduce mortality and should be prescribed in a tapering dose along with anti-tuberculous therapy.

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Correspondence to Hanif Esmail .

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Esmail, H., Cooke, G.S. (2021). Tuberculosis of the Central Nervous System. In: Kon, O.M. (eds) Tuberculosis in Clinical Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-75509-6_6

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  • DOI: https://doi.org/10.1007/978-3-030-75509-6_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-75508-9

  • Online ISBN: 978-3-030-75509-6

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