Clinical findings in patients may include:
(1) fever
(2) vomiting
(3) anorexia with weight loss
(4) seizures
(5) irritability
(6) chronic cough
(7) weakness and/or refusal to walk
(8) headache
(9) depressed level of consciousness
(10) hyponatremia
Findings on CT scan of the head:
(1) hydrocephalus
(2) basilar enhancement
(3) parenchymal lesions
Diagnostic criteria for tuberculosis as the cause - both of the following:
(1) pleocytosis in the CSF (>= 10 inflammatory cells per µL, predominantly lymphocytes)
(2) evidence of Mycobacterium tuberculosis with one or more of the following:
(2a) positive CSF culture
(2b) positive PCR assay on CSF
(2c) acid fast bacilli seen on CSF smear
(2d) positive gastric aspirate culture and/or AFB smear
(2e) positive tuberculin skin test (see below) AND evidence of tuberuculous meningitis (positive CT scan and/or close contact with known/suspected case of tuberculosis)
|
Age
|
Tuberculin Skin Test
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Close Contact with Known/Suspected TB Case
|
|
< 4 years
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>= 10
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none
|
|
>= 4 years
|
>= 15 mm
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none
|
|
any age
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>= 5
|
present
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Exclusions:
(1) other causes of meningitis
(2) AFB contaminants from tap water or other sources
