infectious diseases
Extrapulmonary Tuberculosis (TB)
Meningeal tuberculosis (TB meningitis)
Meningitis often occurs in the absence of infection at other extrapulmonary sites. In the US, it is most common among the elderly and immunocompromised, but in areas where TB is common among children, TB meningitis usually occurs between birth and 5 years. At any age, meningitis is the most serious form of TB and has high morbidity and mortality. It is the one form of TB shown to be prevented in childhood by vaccination with Asymptomatic neonates whose mother or close contacts have active TB . Symptoms are low-grade fever, unremitting headache, nausea, and drowsiness, which may progress to stupor and coma. Kernig and Brudzinski signs may be positive. Because the early signs are non-specific, it is important to consider the diagnosis early in any patient with known TB exposure, infection, or disease, including past TB, and in all persons with compatible symptoms from high TB-burden locations. Stages are 1: Clear sensorium with abnormal CSF 2: Drowsiness or stupor with focal neurologic signs 3: Coma Stroke may result from thrombosis of a major cerebral vessel. Focal neurologic symptoms suggest a tuberculoma. 