Table of Contents
What will be CSF findings in tuberculous meningitis?
Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples.
What is the CT scan findings of patients with TB meningitis?
In tuberculosis meningitis (TBM), contrast-enhanced CT scanning of the brain depicts prominent leptomeningeal and basal cistern enhancement. With ependymitis, linear periventricular enhancement is present. Ventricular dilatation (eg, dilatation of the third and fourth ventricles) due to hydrocephalus is usually seen.
Can TB be detected in CSF?
Mycobacterium tuberculosis (M. tuberculosis) DNA can be detected in CSF using polymerase chain reaction (PCR). However, due to a high rate of false-positive results and exacting experimental conditions, PCR is unlikely to be widely used in underdeveloped areas.
Which CSF results are most consistent with bacterial meningitis?
The CSF protein level (reference range, 20-50 mg/dL) is usually elevated in bacterial meningitis. In viral meningitis, these levels are also usually elevated, though they can be within the reference range.
How can meningitis appear on CT scan?
The CT scan is a valuable tool in diagnosing meningitis. The contrast dye that is injected during the test can highlight brain, skull, and sinus inflammation- all complications and signs of meningitis.
What is basal exudates in TB meningitis?
tuberculosis in the cerebrospinal fluid (CSF) results in pathogenic mechanisms responsible for tuberculous meningitis. The most characteristic pathologic feature of tuberculous meningitis is meningeal inflammation and formation of thick gelatinous exudates in the basal parts of the brain.
Can CSF be normal in TB meningitis?
Although in typical TB meningitis there is significant pleocytosis with lymphocyte predominance and high CSF protein levels and significant decrease of CSF glucose levels (hypoglycorrhachia), but in the first 2-3 weeks of symptom initiation, typical CSF pattern of TB meningitis may be absent.
Why is CSF glucose low in tuberculous meningitis?
During the recovery phase in the treatment of meningitis, CSF glucose normalizes before protein levels and cell counts. Patients with chronic tuberculous meningitis have abnormal CSF with lymphocytic pleocytosis, decreased glucose and increased protein (2).
Which laboratory result would verify the diagnosis of bacterial meningitis?
Laboratory examination of the CSF is usually the first step to confirm the presence of bacterial meningitis. Note that cytological examination should precede centrifugation and heating of the CSF.
WHO TB meningitis treatment guidelines?
Current WHO guidelines for TBM are based on those developed to treat PTB and suggest treatment with 2 months of rifampicin (RMP), isoniazid (INH), pyrazinamide (PZE) and ethambutol (ETB) followed by up to 10 months of RMP and INH for all patients [7].