Neurology » Infections

CNS Tuberculosis

Tuberculosis (TB) of the central nervous system (CNS) is a granulomatous infection caused by Mycobacterium tuberculosis. Predisposing factors for development of active TB include malnutrition, alcoholism, substance abuse, diabetes mellitus, corticosteroid use, malignancy, head trauma, and HIV infection. CNS TB usually takes the form of meningitis that causes an acute to subacute illness characterized by fever, headache, drowsiness, meningism, and confusion. CSFexamination typically shows elevated protein level, low glucose levels, and a pleocytosis, initially polymorphs then lymphocytes. AKT- isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and streptomycin (SM) are given for 6-9 months. In patients with evidence of obstructive hydrocephalus and neurological deterioration, placement of a ventricular drain or ventriculoperitoneal or ventriculoatrial shunt may be indicated. .

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