Presentation
The genotype of M. tuberculosis influenced the presenting features of pulmonary and meningeal tuberculosis. [ncbi.nlm.nih.gov]
Fever and headache are the most common presenting signs, and symptoms are present on average for about 2 weeks prior to presentation. Change in mental status is seen in about 70%. [clinicaladvisor.com]
[…] meningitis, unspecified convert 013.00 to ICD-10-CM 013.01 Tuberculous meningitis, bacteriological or histological examination not done convert 013.01 to ICD-10-CM 013.02 Tuberculous meningitis, bacteriological or histological examination unknown (at present [icd9data.com]
In our study, all those who presented with focal signs died. [aidsrestherapy.biomedcentral.com]
Entire Body System
- Fever
This will usually show that you have the following: Fast heart rate Fever Mental status changes Stiff neck A lumbar puncture ( spinal tap ) is an important test in diagnosing meningitis. [nlm.nih.gov]
At the first contact to a doctor, seven patients were diagnosed as having common cold or headache related with fever because of the lack of typical signs of meningitis. [ncbi.nlm.nih.gov]
During the early stage of infection patient may complain of tiredness, weakness, mild grade fever, loss of appetite. [tandurust.com]
Important risk factors include: HIV/AIDS immunosuppression diabetes mellitus alcoholism Low grade fever with headache is a prodromal manifestation. Most common clinical manifestations are fever, headache, vomiting and neck stiffness. [radiopaedia.org]
Signs of meningitis may include altered mental status, fever, seizures, etc. [doctor.ndtv.com]
- Fatigue
Tuberculois meningitis begins insidiously with a gradual fluctuating fever, fatigue, weight loss, behavior changes, headache, and vomiting. This early phase is followed by neurologic deficits, loss of consciousness, or convulsions. [medicinenet.com]
During the early stages of the infection, symptoms can include: fatigue malaise low-grade fever As the disease progresses, the symptoms will become more serious. [healthline.com]
But the common symptoms include fatigue, weight loss, loss of appetite, and fever. [dovemed.com]
Tuberculous Meningitis Symptoms TBM can give rise to the following signs and symptoms: Chills Fever Coma Stroke Fatigue Nausea Malaise Myalgia Aphasia Seizures Tremors Agitation Vomiting Dizziness Blindness Headache Confusion Myoclonus Hemiplegia Monoplegia [hxbenefit.com]
General symptoms : fatigue, malaise, fever, weight loss, anorexia, failure to thrive and pyrexia of unknown origin (PUO). Pulmonary : respiratory TB accounts for 60% of cases in the UK. [patient.info]
- Poor Feeding
feeding or irritability in children Unusual posture, with the head and neck arched backward ( opisthotonos ). [nlm.nih.gov]
[…] status Tuberculous spondylitis Decreased consciousness Meningismus or stiff neck Focal neurological deficits Sensorineural hearing loss Bulging fontanelles in infants Changes in the mental status Tuberculous encephalopathy Tuberculous spinal meningitis Poor [hxbenefit.com]
Gastrointestinal
- Vomiting
In the beginning the symptoms are vague, but gradually the symptoms become more obvious which include severe vomiting, fever, severe headache, neck rigidity, and mental confusion. Seizures may develop in some patients. [tandurust.com]
DAY TO DAY ASSESSMENT Day 1- c/o- o chronic Headache on and off from 15 days. o vomiting Medication- Tab. Calpol (paracetamol) 650 mg SOS Vitals- NORMAL Advice: Chest x-ray 10. Day 2- Pt.stable Montox reactive Vitals normal Rx- Inj. [slideshare.net]
Early diagnosis is difficult because patients tend to present subacutely with nonspecific symptoms such as fever, cough, vomiting, listlessness, and failure to thrive. [ncbi.nlm.nih.gov]
Tuberculois meningitis begins insidiously with a gradual fluctuating fever, fatigue, weight loss, behavior changes, headache, and vomiting. This early phase is followed by neurologic deficits, loss of consciousness, or convulsions. [medicinenet.com]
Vague symptoms such as vomiting, fever and lethargy were most common in early tuberculous meningitis and rarely stimulated a prompt diagnosis. Headache was a frequent complaint in children over 4 years, but was uncommon in those under 4 years. [pediatrics.aappublications.org]
- Nausea
Common complaints include headaches, stiff neck, fever, weight loss, blurred vision, confusion, lethargy, nausea, vomiting and for spinal cord lesions - lower extremity weakness or bowel or bladder symptoms. [doctor.ndtv.com]
People who have the following have a higher chance of developing tuberculous meningitis: HIV/AIDS Drink alcohol in excess TB of the lung Weakened immune system The symptoms often start slowly, and may include: Fever and chills Mental status changes Nausea [nlm.nih.gov]
The patient was a 25-year-old female who was admitted to our hospital on Dec 10, 1996 because of fever, nausea, and headache. [ginmu.naramed-u.ac.jp]
These stages are described below: Stage I This first stage is characterized by the presence of nonspecific symptoms such as irritability, apathy, fever, malaise, headache, vomiting, nausea and anorexia without any changes in the levels of consciousness [hxbenefit.com]
Instead, you may experience the following symptoms: fever confusion nausea and vomiting lethargy irritability unconsciousness Your doctor will perform a physical exam and ask you about your symptoms and medical history. [healthline.com]
- Loss of Appetite
During the early stage of infection patient may complain of tiredness, weakness, mild grade fever, loss of appetite. [tandurust.com]
[…] initially display vague symptoms such as aches and pains, loss of appetite and tiredness, usually with a persistent headache These vague symptoms can last for several weeks before more specific symptoms of meningitis, such as severe headache, dislike [meningitisnow.org]
But the common symptoms include fatigue, weight loss, loss of appetite, and fever. [dovemed.com]
Neurologic
- Meningism
meningitis 013.0 Leptomeningitis (chronic) (circumscribed) (hemorrhagic) (nonsuppurative) (see also Meningitis) 322.9 tuberculous (see also Tuberculosis, meninges) 013.0 Meningitis (basal) (basic) (basilar) (brain) (cerebral) (cervical) (congestive) [icd9data.com]
C ► CT images of tuberculous meningitis (1 F) G ► Gross pathology of tuberculous meningitis (2 F) H ► Histopathology of tuberculous meningitis (1 F) File nella categoria "Tuberculous meningitis" Questa categoria contiene 2 file, indicati di seguito [commons.wikimedia.org]
Tuberculous meningitis is also known as TB meningitis or tubercular meningitis. Tuberculous meningitis is Mycobacterium tuberculosis infection of the meninges—the system of membranes which envelop the central nervous system. [en.wikipedia.org]
Tuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges). Tuberculous meningitis is caused by Mycobacterium tuberculosis. This is the bacterium that causes tuberculosis ( TB ). [nlm.nih.gov]
- Headache
At the first contact to a doctor, seven patients were diagnosed as having common cold or headache related with fever because of the lack of typical signs of meningitis. [ncbi.nlm.nih.gov]
Important risk factors include: HIV/AIDS immunosuppression diabetes mellitus alcoholism Low grade fever with headache is a prodromal manifestation. Most common clinical manifestations are fever, headache, vomiting and neck stiffness. [radiopaedia.org]
In the beginning the symptoms are vague, but gradually the symptoms become more obvious which include severe vomiting, fever, severe headache, neck rigidity, and mental confusion. Seizures may develop in some patients. [tandurust.com]
Classic symptoms of meningitis, such as stiff neck, headache, and light sensitivity, are not always present in meningeal tuberculosis. [healthline.com]
- Seizure
Seizures are commonly observed in children. Without treatment the disease progresses rapidly which may lead to coma and death of the patient. [tandurust.com]
Headache and meningeal irritation may be followed by SEIZURES, cranial neuropathies, focal neurologic deficits, somnolence, and eventually COMA. [connects.catalyst.harvard.edu]
Stage III This final stage is marked by an advanced state of coma or stupor, seizures, dense neurological deficits, posturing as well as abnormal movements. [hxbenefit.com]
When the diagnosis of meningitis was obtained based on the findings of the cerebrospinal fluid (CSF), focal neurological signs including psychological symptoms, cranial nerve palsies and seizure were noted besides meningeal signs or the disturbance of [ncbi.nlm.nih.gov]
Signs of meningitis may include altered mental status, fever, seizures, etc. [doctor.ndtv.com]
- Irritability
Nausea and vomiting Sensitivity to light ( photophobia ) Severe headache Stiff neck (meningismus) Other symptoms that can occur with this disease may include: Agitation Bulging fontanelles (soft spots) in babies Decreased consciousness Poor feeding or irritability [nlm.nih.gov]
English meningeal irritation Last Update: 2014-12-09 Usage Frequency: 6 Quality: Warning: This alignment may be wrong. Please delete it you feel so. [mymemory.translated.net]
Headache and meningeal irritation may be followed by SEIZURES, cranial neuropathies, focal neurologic deficits, somnolence, and eventually COMA. [connects.catalyst.harvard.edu]
Infections (viral, bacterial, and fungal) are the most common causes of this condition, but subarachnoid hemorrhage (hemorrhages, subarachnoid), chemical irritation (chemical meningitis), granulomatous conditions, neoplastic conditions (carcinomatous [icd9data.com]
These stages are described below: Stage I This first stage is characterized by the presence of nonspecific symptoms such as irritability, apathy, fever, malaise, headache, vomiting, nausea and anorexia without any changes in the levels of consciousness [hxbenefit.com]
- Confusion
In the beginning the symptoms are vague, but gradually the symptoms become more obvious which include severe vomiting, fever, severe headache, neck rigidity, and mental confusion. Seizures may develop in some patients. [tandurust.com]
Fever and headache are the cardinal features; confusion is a late feature and coma bears a poor prognosis. Meningism is absent in a fifth of patients with TB meningitis. Patients may also have focal neurological deficits. [en.wikipedia.org]
Common complaints include headaches, stiff neck, fever, weight loss, blurred vision, confusion, lethargy, nausea, vomiting and for spinal cord lesions - lower extremity weakness or bowel or bladder symptoms. [doctor.ndtv.com]
Instead, you may experience the following symptoms: fever confusion nausea and vomiting lethargy irritability unconsciousness Your doctor will perform a physical exam and ask you about your symptoms and medical history. [healthline.com]
Tuberculous Meningitis Symptoms TBM can give rise to the following signs and symptoms: Chills Fever Coma Stroke Fatigue Nausea Malaise Myalgia Aphasia Seizures Tremors Agitation Vomiting Dizziness Blindness Headache Confusion Myoclonus Hemiplegia Monoplegia [hxbenefit.com]
Workup
(See Workup.) Prompt treatment is essential; death may occur as a result of missed diagnoses and delayed treatment. Antimicrobial therapy is best started with isoniazid, rifampin, pyrazinamide; addition of a fourth drug is left to local choice. [emedicine.medscape.com]
Skin Test
- Anergy
Anergy to tuberculin was uncommon; only 2% of the patients reacted negatively to 1.0 mg. O.T. Forty-eight per cent of the cases occurred before the age of 2 years, and two thirds before the age of 4 years. [pediatrics.aappublications.org]
Anergy, or absence of PPD reactivity in persons infected with TB, can occur in immunocompromised persons, or it may even occur in persons newly infected with TB, or in persons with miliary TB. Injecting PPD intracutaneously, gross. [library.med.utah.edu]
Serum
- Lymphocytosis
CSF analysis reveals lymphocytosis, increased protein level and decreased glucose levels. Tuberculous meningitis is caused by Mycobacterium tuberculosis. [radiopaedia.org]
CNS Tuberculosis: A meningeal pattern of spread can occur, and the cerebrospinal fluid typically shows a high protein, low glucose, and lymphocytosis. The base of the brain is often involved, so that various cranial nerve signs may be present. [library.med.utah.edu]
Acellular CSF in elderly and HIV positive patients have been reported. 49 Lymphocytosis of between 100 and 1000 cells/mm 3 is more usual, although in the first 10 days polymorphonuclear leucocytes may predominate. 59 A raised CSF protein occurs in most [jnnp.bmj.com]
Treatment
We compared in-hospital treatment outcome of patients on thrice weekly intermittent DOTS regimen with daily regimen patients. RESULTS: The inhospital mortality was same (27%) in the two treatment regimens (p 0.944). [ncbi.nlm.nih.gov]
After two months of treatment, patient has to take 3 anti tubercular drugs for 7 to 10 months. Thus the treatment may last for 12 months. The time period of treatment may depend on the response of drugs on the patient. [tandurust.com]
ELISPOT testing is not useful for the diagnosis of acute TB meningitis and is often false negative, but may paradoxically become positive after treatment has started, which helps to confirm the diagnosis. [en.wikipedia.org]
Prognosis
Prognosis is related directly to the clinical stage at diagnosis. (See Prognosis.) TBM may have an acute presentation. [emedicine.medscape.com]
Etiology
Similarly three other patients were initially diagnosed as having meningitis due to viral infection or unknown etiology. [ncbi.nlm.nih.gov]
The etiology and the initial period of tuberculous meningitis, the principle forms of evolution, complications, clinical forms, cerebrospinal fluid, bacteriology, the [jamanetwork.com]
(Etiology) Disseminated Tuberculosis is a contagious bacterial infection that has spread from the lungs to other parts of the body through the blood or lymph system It is caused by Mycobacterium tuberculosis, a pathogenic bacterium The infection is acquired [dovemed.com]
When no inflammatory, infectious or tumoral etiology or evidence of intracranial hypotension is present, a diagnosis of idiopathic pachymeningitis is considered, with possible dural calcifications. [em-consulte.com]
Etiology The causative organism is Mycobacterium tuberculosis. Various risk factors have been identified. The first description of TBM is credited to Robert Whytt, on the basis of his 1768 monograph, Observations of Dropsy in the Brain. [emedicine.medscape.com]
Epidemiology
The diagnosis is mainly clinical and should be considered in a specific epidemiological context. Culture of Mycobacterium tuberculosis from cerebrospinal fluid is required for definitive diagnosis but it cannot always be obtained. [moh-it.pure.elsevier.com]
(See Epidemiology.) TBM is a very critical disease in terms of fatal outcome and permanent sequelae, requiring rapid diagnosis and treatment. [emedicine.medscape.com]
For LTBI, research needs to address different epidemiological and clinical settings, to evaluate the performance of the main existing commercial assays in head-to-head comparison in both developed and developing countries, and to assess the role of adding [ncbi.nlm.nih.gov]
Pathophysiology
The pathophysiology of tuberculous meningitis has bacilli root itself to the brain parenchyma, which causes the formation of small subpial focus. Then there is an increase in size of Rich focus until rupture. [en.wikipedia.org]
(See Pathophysiology.) Currently, more than 2 billion people (ie, one third of the world’s population) are infected with tuberculosis (TB), of which approximately 10% will develop clinical disease. [emedicine.medscape.com]
Prevention
Treating people who have signs of a non-active (dormant) TB infection can prevent its spread. A PPD test and other TB tests can be done to tell if you have this type of infection. [nlm.nih.gov]
Cases were patients with microbiologically proven tuberculous meningitis; controls were patients in whom Mycobacterium tuberculosis could not be isolated but met the Centers for Diseases Control and Prevention (CDC) criteria for non-proven tuberculous [ncbi.nlm.nih.gov]
You should seek medical care quickly if you have a sudden fever a severe headache a stiff neck early treatment can help prevent serious problems, including death. Vaccines can prevent some of the bacterial infections that cause meningitis. [icd9data.com]
The best way to prevent TB meningitis is to prevent TB infections. In communities where TB is common, the Bacillus Calmette-Guérin (BCG) vaccine can help control the spread of the disease. [healthline.com]
Disseminated TB can be prevented by early diagnosis and treatment of pulmonary tuberculosis. [dovemed.com]