BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuMeningitis - tuberculousTubercular meningitis; TB meningitisTuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges). Causes Tuberculous meningitis is caused by Mycobacterium tuberculosis. This is the bacterium that causes tuberculosis (TB). The bacteria spread to the brain and spine from another place in the body, usually the lung.TBPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Tuberculous meningitis is very rare in the United States. Most cases are in people who traveled to the United States from other countries where TB is common.People who have the following have a higher chance of developing tuberculous meningitis:HIV/AIDS HIV/AIDSHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Drink alcohol in excess Drink alcohol in excessAlcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...ImageRead Article Now Book Mark Article TB of the lung TB of the lungPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Weakened immune system Symptoms The symptoms often start slowly, and may include:Fever and chills Mental status changes Mental status changesConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Nausea and vomiting Sensitivity to light (photophobia) PhotophobiaPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Severe headache Stiff neck (meningismus)Other symptoms that can occur with this disease may include:Agitation Bulging fontanelles (soft spots) in babies Bulging fontanellesA bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).ImageRead Article Now Book Mark Article Decreased consciousness Poor feeding or irritability in children Unusual posture, with the head and neck arched backward (opisthotonos). This is usually found in infants (less than 3 months old)OpisthotonosOpisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...Read Article Now Book Mark Article Exams and Tests The health care provider will examine you. 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. It is done to collect a sample of spinal fluid for examination. More than one sample may be needed to make the diagnosis.Spinal tapCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Other tests that may be done include:Biopsy of the brain or meninges (rare) BiopsyA biopsy is the removal of a small piece of tissue for laboratory examination.Read Article Now Book Mark Article Blood culture Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) examination for cell count, glucose, and protein Cerebrospinal fluid (CSF) examinationCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article CT scan of the head CT scan of the headA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Gram stain, other special stains, and culture of CSF Culture of CSFA cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the fluid that moves in the space around the spi...ImageRead Article Now Book Mark Article Polymerase chain reaction (PCR) of CSF Skin test for TB (PPD) PPDThe PPD skin test is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative.ImageRead Article Now Book Mark Article Other tests to look for TB Treatment You will be given several medicines to fight the TB bacteria. Sometimes, treatment is started even if your provider thinks you have the disease, but testing has not confirmed it yet.Treatment usually lasts for at least 12 months. Medicines called corticosteroids may also be used. Outlook (Prognosis) Tuberculous meningitis is life threatening if untreated. Long-term follow-up is needed to detect recurring infections. Possible Complications Untreated, the disease can cause any of the following:Brain damage Build-up of fluid between the skull and brain (subdural effusion) Subdural effusionA subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...Read Article Now Book Mark Article Hearing loss Hydrocephalus (buildup of fluid inside the skull that leads to brain swelling) HydrocephalusHydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...ImageRead Article Now Book Mark Article Seizures SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Death When to Contact a Medical Professional Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:Feeding problems High-pitched cry Irritability Persistent unexplained fever Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness. 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.Some countries with a high incidence of TB give people a vaccine called BCG to prevent TB. But, the effectiveness of this vaccine is limited, and it is not usually used in the United States. The BCG vaccine may help prevent severe forms of TB, such as meningitis, in very young children who live in areas where the disease is common.Open ReferencesReferencesCruz AT, Starke JR. Tuberculosis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 96.Ellner JJ, Jacobson KR. Tuberculosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 308.Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 249.AllVideoImagesTogMeninges of the brain - illustration The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the brainillustrationMeninges of the spine - illustration The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the spineillustrationMeninges of the brain - illustration The organs of the central nervous system (brain and spinal cord) are covered by connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the brainillustrationMeninges of the spine - illustration The organs of the central nervous system (brain and spinal cord) are covered by 3 connective tissue layers collectively called the meninges. Consisting of the pia mater (closest to the CNS structures), the arachnoid and the dura mater (farthest from the CNS), the meninges also support blood vessels and contain cerebrospinal fluid. These are the structures involved in meningitis, an inflammation of the meninges, which, if severe, may become encephalitis, an inflammation of the brain.Meninges of the spineillustrationRelated Information Pulmonary tuberculosis(Condition)Alcohol use and safe drinking(Special Topic)HIV/AIDS(Condition)Muscle function loss(Symptoms)Seizures(Symptoms) Review Date: 12/4/2022 Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 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Meningitis - tuberculousTubercular meningitis; TB meningitisTuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges). Causes Tuberculous meningitis is caused by Mycobacterium tuberculosis. This is the bacterium that causes tuberculosis (TB). The bacteria spread to the brain and spine from another place in the body, usually the lung.TBPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Tuberculous meningitis is very rare in the United States. Most cases are in people who traveled to the United States from other countries where TB is common.People who have the following have a higher chance of developing tuberculous meningitis:HIV/AIDS HIV/AIDSHuman immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...ImageRead Article Now Book Mark Article Drink alcohol in excess Drink alcohol in excessAlcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...ImageRead Article Now Book Mark Article TB of the lung TB of the lungPulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs. It may spread to other organs.ImageRead Article Now Book Mark Article Weakened immune system Symptoms The symptoms often start slowly, and may include:Fever and chills Mental status changes Mental status changesConfusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...ImageRead Article Now Book Mark Article Nausea and vomiting Sensitivity to light (photophobia) PhotophobiaPhotophobia is eye discomfort in bright light.ImageRead Article Now Book Mark Article Severe headache Stiff neck (meningismus)Other symptoms that can occur with this disease may include:Agitation Bulging fontanelles (soft spots) in babies Bulging fontanellesA bulging fontanelle is an outward curving of an infant's soft spot (fontanelle).ImageRead Article Now Book Mark Article Decreased consciousness Poor feeding or irritability in children Unusual posture, with the head and neck arched backward (opisthotonos). This is usually found in infants (less than 3 months old)OpisthotonosOpisthotonos is a condition in which a person holds their body in an abnormal position. The person is usually rigid and arches their back, with thei...Read Article Now Book Mark Article Exams and Tests The health care provider will examine you. 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. It is done to collect a sample of spinal fluid for examination. More than one sample may be needed to make the diagnosis.Spinal tapCerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...ImageRead Article Now Book Mark Article Other tests that may be done include:Biopsy of the brain or meninges (rare) BiopsyA biopsy is the removal of a small piece of tissue for laboratory examination.Read Article Now Book Mark Article Blood culture Blood cultureA blood culture is a laboratory test to check for bacteria or other germs in a blood sample.ImageRead Article Now Book Mark Article Chest x-ray Chest x-rayA chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.ImageRead Article Now Book Mark Article Cerebrospinal fluid (CSF) examination for cell count, glucose, and protein Cerebrospinal fluid (CSF) examinationCerebrospinal fluid (CSF) analysis is a group of laboratory tests that measure chemicals in the cerebrospinal fluid. CSF is a clear fluid that surro...ImageRead Article Now Book Mark Article CT scan of the head CT scan of the headA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Gram stain, other special stains, and culture of CSF Culture of CSFA cerebrospinal fluid (CSF) culture is a laboratory test to look for bacteria, fungi, and viruses in the fluid that moves in the space around the spi...ImageRead Article Now Book Mark Article Polymerase chain reaction (PCR) of CSF Skin test for TB (PPD) PPDThe PPD skin test is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative.ImageRead Article Now Book Mark Article Other tests to look for TB Treatment You will be given several medicines to fight the TB bacteria. Sometimes, treatment is started even if your provider thinks you have the disease, but testing has not confirmed it yet.Treatment usually lasts for at least 12 months. Medicines called corticosteroids may also be used. Outlook (Prognosis) Tuberculous meningitis is life threatening if untreated. Long-term follow-up is needed to detect recurring infections. Possible Complications Untreated, the disease can cause any of the following:Brain damage Build-up of fluid between the skull and brain (subdural effusion) Subdural effusionA subdural effusion is a collection of cerebrospinal fluid (CSF) trapped between the surface of the brain and the outer lining of the brain (the dura...Read Article Now Book Mark Article Hearing loss Hydrocephalus (buildup of fluid inside the skull that leads to brain swelling) HydrocephalusHydrocephalus is a buildup of fluid inside the skull that leads to the brain pushing against the skull. Hydrocephalus means "water on the brain. "...ImageRead Article Now Book Mark Article Seizures SeizuresA seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...ImageRead Article Now Book Mark Article Death When to Contact a Medical Professional Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:Feeding problems High-pitched cry Irritability Persistent unexplained fever Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness. 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.Some countries with a high incidence of TB give people a vaccine called BCG to prevent TB. But, the effectiveness of this vaccine is limited, and it is not usually used in the United States. The BCG vaccine may help prevent severe forms of TB, such as meningitis, in very young children who live in areas where the disease is common.Open ReferencesReferencesCruz AT, Starke JR. Tuberculosis. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 96.Ellner JJ, Jacobson KR. Tuberculosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 308.Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 249.