Abstract:
Infection of the central nervous system (CNS) caused by Mycobacterium tuberculosis
is rare yet highly devastating and potentially lethal manifestation of tuberculosis (TB).
In spite of a current global decrease of incident cases, TB persists a prominent cause
of death on a worldwide scale.
On account of its rarity (1-2% of active TB) and variable nature of symptoms, TB with
CNS involvement remains a diagnostic challenge while any delay in implementation
of specific treatment may result in worsening the prognosis. Despite the availability of
effective treatment, there are still numerous cases of deaths among patients as an effect
of late diagnosis.
Early diagnosis is essential for the result of treatment, yet tricky because patients
tend to present subacute course with nonspecific symptoms. Significant proportion
of patients may suffer from sever neurologic disability. The review describes clinical
features and diagnostic procedures regarding TBM in children as well as the method
of treatment.
Provision of adequate multi-drug anti-tuberculosis treatment in conjunction with
adjunctive corticosteroids is likely to achieve a good prognosis in patients with TMB.
TBM should be kept in mind this diagnosis when encountering patients with
meningitis of unknown origin and uncertain history. Main concerns should include the
advancement of diagnostic testing strategies and the optimization of anti-tuberculosis
therapies.
Description:
Infection of the central nervous system (CNS) caused by Mycobacterium tuberculosis
is rare yet highly devastating and potentially lethal manifestation of tuberculosis (TB).
In spite of a current global decrease of incident cases, TB persists a prominent cause
of death on a worldwide scale.
On account of its rarity (1-2% of active TB) and variable nature of symptoms, TB with
CNS involvement remains a diagnostic challenge while any delay in implementation
of specific treatment may result in worsening the prognosis. Despite the availability of
effective treatment, there are still numerous cases of deaths among patients as an effect
of late diagnosis.
Early diagnosis is essential for the result of treatment, yet tricky because patients
tend to present subacute course with nonspecific symptoms. Significant proportion
of patients may suffer from sever neurologic disability. The review describes clinical
features and diagnostic procedures regarding TBM in children as well as the method
of treatment.
Provision of adequate multi-drug anti-tuberculosis treatment in conjunction with
adjunctive corticosteroids is likely to achieve a good prognosis in patients with TMB.
TBM should be kept in mind this diagnosis when encountering patients with
meningitis of unknown origin and uncertain history. Main concerns should include the
advancement of diagnostic testing strategies and the optimization of anti-tuberculosis
therapies.
