TUBERCULOSIS MENINGITIS IN CHILDREN

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.