Tuberculosis Meningitis(TB) is a severe form of TB caused by the bacteria Mycobacterium tuberculosis. Tuberculosis occurs due to the presence of the bacteria. The infection spreads in the brain tissues and meninges from the lungs. Tb meningitis may occur in children and adults of all age groups. Though it is a rare form of TB, and the ratio of mortality or disability is high. The risk factors that can be fatal for those who are having a history of:
- Alcoholism
- HIV/AIDS
- Weak immunity system
- Diabetes
Symptoms of TBM
- Fever
- Nausea
- Vomiting
- Stiffness in neck
- Headache
- Lethargy
- Drowsiness
- convulsions
If TBM remains untreated hydrocephalus, deafness, mental retardation, paralysis, neurological abnormalities may occur. Tuberculosis meningitis is a rare disease that occurs in patients who already have TB, especially miliary tuberculosis.
Diagnosis
Clinical Diagnosis: Doctors may diagnose the infection by analyzing cerebrospinal fluids while diagnosing TBM. A spiderweb clot that presents in the CSF may diagnose as TB meningitis. Doctors rarely found the bacteria, as soon as the treatment starts, they become confirm about TBM. A NAAT(Nucleic acid amplification tests) is a group of tests performs in detecting the mycobacterial nucleic acid by using polymerase chain reaction. The two common tests that helpful in diagnosing TBM are the amplified mycobacterium tuberculosis direct test and Amplicor.
Microbiological Diagnosis: Smear microscopy is a widely used diagnostic test. Though the test is not fully reliable in diagnosing TBM disease. World Health Organization recommends Mycobacterial Culture for adults and children.
Molecular Tests: NAAT shows a performance that is based on the pooled sensitivity of 96% respectively. A pooled sensitivity is based on the surveillance and screening of the sample size of each sample.
Brain Imaging: the two techniques of brain imaging test are CT scan and MRI. Brain imaging tests involve the better detection of the infection.
Immunodiagnostic tests: interferon-gamma release assays(IGRA) involve the diagnosis of the TBM infection. WHO recommends the test to those individuals who are at acute risk.
Treatment
Doctors may prescribe systemic steroids to the patients to reduce complications. Treatment may take up to 12 months as per the complications and severity of the conditions. Doctors may prescribe the patients to admit to the hospital. Meningitis is usually treated with antibiotics prescribed by the doctors. Four drugs that are helpful in the treatment of TBM :
- Isoniazid
- Rifampin
- Pyrazinamide
- Ethambutol
Doctors may suggest a fluoroquinolone, in place of Ethambutol. The treatment may last for 12 months.
Prevention
To prevent the infection of TBM, prevention of TB and vaccination play a significant role. The Bacillus Calmette-Guerin(BCG) vaccine helps to control the spread of the disease. People with dormant TB infections can also spread the disease. A person with dormant TB infections may test positive for TB but shows no symptoms of the disease.
PPD skin tests in tuberculosis
PPD (purified protein derivative) skin tests determine whether the person is suffering from TB.PPD test involves checking the body current sensitivity of the patient. PPD skin test is required:
- TB is a contagious disease. A person may develop an infection if he/ she may around the TB patient.
- A person may have a weakened immune system.
HIV-associated TBM
Over the years, TBM is the most severe form of Tuberculosis. The best way to improve the clinical trials and decrease the mortality rate through accurate diagnosis and prompt initiative. The disease may cure by more advancement in treatment and diagnosis. HIV-associated TBM patients often encountered death.
Suresh Hospital’s Pulmonology ../department
Suresh Hospitals are known for their State-of-the-Art Pulmonology ../department. The Labs are well-equipped with modern amenities with an experienced team of Pulmonologists. They have dedicated themselves to the wellness of the patients. Respiratory diseases like tuberculosis, chest infections, asthma are being treated with great empathy.