A granulomatous infection of the brain, meninges, or spinal cord caused by Mycobacterium tuberculosis
Central nervous system tuberculosis (CNS TB) includes tuberculous meningitis, int...
Assess patient risk.
Malaise, fever, headache, vomiting
Confusion, seizures, altered mental status
Neurologic exam
Meningismus; altered mental status/lethargy/coma
Papilledema...
Early diagnosis improves outcomes.
Start treatment empirically if clinical suspicion is high. Delayed treatment can lead to fatal outcomes.
Treatment guidelines for CNS TB are based on pulmona...
Look for other foci of infection.
Institute seizure precautions.
Neuropsychological surveillance
Treat concurrent HIV infection, if present.
Assess ...
A17.9 Tuberculosis of nervous system, unspecified
A17.0 Tuberculous meningitis
A17.81 Tuberculoma of brain and spinal cord
A17.82 Tuberculous meningoencephalitis
A17.1 Meningeal tuberculoma
A17....
Include four drugs (isoniazid, rifampin, pyrazinamide, and ethambutol) for 2 months for initial treatment of CNS TB, followed by isoniazid and rifampin for 10 months.
Adjunctive dexamet...
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Necrotizing granuloma due to M. tuberculosis. A small tuberculous granuloma with conspicuous central caseation is present in the pulmonary parenchyma.
Necrotizing granuloma due to M. tuberculosis. A small tuberculous granuloma with conspicuous central caseation is present in the pulmonary...
Cavitary tuberculosis. The apex of the left upper lobe shows tuberculous cavities surrounded by consolidated and fibrotic pulmonary parenchyma, which contains small tubercles.
Cavitary tuberculosis. The apex of the left upper lobe shows tuberculous cavities surrounded by consolidated and fibrotic pulmonary parenc...
Miliary tuberculosis. Multiple millimeter-sized nodules are scattered throughout the lung parenchyma.
Tuberculous spondylitis (Pott disease). A vertebral body is almost completely replaced by tuberculous tissue. Note the preservation of the intervertebral discs.
Tuberculous spondylitis (Pott disease). A vertebral body is almost completely replaced by tuberculous tissue. Note the preservation of the...
Mycobacterium tuberculosis. A smear of a pulmonary lesion shows slender, beaded, acid-fast bacilli.
FIGURE 20.3. Chest radiograph (posteroanterior view only) demonstrating the radiographic presentation of miliary tuberculosis.
FIGURE 20.4. Chest radiographs (posteroanterior and lateral views) demonstrating cavitary reactivation of latent tuberculosis infection in the posterior apical segment of the right upper lobe.
FIGURE 20.4. Chest radiographs (posteroanterior and lateral views) demonstrating cavitary reactivation of latent tuberculosis infection in...
Figure 189.1. Chest radiograph demonstrating apical infiltrate with cavitation, typical of pulmonary tuberculosis.