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Tuberculosis, CNS

Matthew J. Putty, DO and Jason M. Seibly, DO, FACOS Reviewed 06/2019
 


BASICS

DESCRIPTION

  • A granulomatous infection of the brain, meninges, or spinal cord caused by Mycobacterium tuberculosis

  • Central nervous system tuberculosis (CNS TB) includes tuberculous meningitis, int...

DIAGNOSIS

HISTORY

  • Assess patient risk.

  • Malaise, fever, headache, vomiting

  • Confusion, seizures, altered mental status

PHYSICAL EXAM

  • Neurologic exam

    • Meningismus

    • Altered mental status/lethargy/coma

    • Papilledema

    • ...

TREATMENT

  • 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...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Look for other foci of infection.

  • Institute seizure precautions.

  • Neuropsychological surveillance

  • Treat concurrent HIV infection, if present.

Patient Monitoring

  • Assess ...

REFERENCES

1
Zunt J. Tuberculosis of the central nervous system. Continuum (Minneap Minn).  2018;24(5):1422–1438. [View Abstract on OvidMedline]
2
Mangtani P, Abubakar I, Ariti C, et al. Protection ...

ADDITIONAL READING

  • DeLance AR, Safaee M, Oh MC, et al. Tuberculoma of the central nervous system. J Clin Neurosci.  2013;20(10):1333–1341. [View Abstract on OvidMedline]

  • Leonard JM. Central nervou...

CODES

ICD10

  • 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....

CLINICAL PEARLS

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