A17.0

Clinical Causes: This condition develops when Mycobacterium tuberculosis bacteria spread from the lungs or other parts of the body to the meninges. The bacteria can reach the meninges through the bloodstream or from direct extension from nearby infected structures. Spread usually occurs in individuals with weakened immune systems, such as those with HIV/AIDS, malnutrition, or other immunocompromising conditions. Tuberculous meningitis is more common in regions where tuberculosis is prevalent, but it can affect anyone with active TB. The primary cause is the dissemination of a primary or latent TB infection to the central nervous system.

Key Symptoms: Persistent headache that worsens over time Fever, often low-grade but persistent Neck stiffness and neck pain Sensitivity to light (photophobia) Altered mental status, including confusion or difficulty concentrating Nausea and vomiting Weakness or fatigue Seizures in some cases Behavioral changes or lethargy in advanced stages

Diagnosis Path: Lumbar puncture (spinal tap) to analyze cerebrospinal fluid (CSF), revealing elevated white blood cell count, increased protein, and decreased glucose levels Microscopic examination and culture of CSF samples to detect Mycobacterium tuberculosis Polymerase chain reaction (PCR) testing for rapid detection of TB DNA in CSF Blood tests such as interferon-gamma release assays (IGRAs) and tuberculin skin testing Imaging studies like MRI or CT scans to identify inflammation, hydrocephalus, or other brain abnormalities

Treatment Protocols: Combination therapy with anti-tuberculous drugs such as isoniazid, rifampicin, pyrazinamide, and ethambutol Prolonged therapy usually lasting 9 to 12 months, depending on disease severity and response Corticosteroids like dexamethasone to reduce inflammation and minimize neurological damage Supportive care to manage symptoms, dehydration, and other complications Monitoring for drug side effects and treatment adherence