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
Altered mental status/lethargy/coma
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.
Treat concurrent HIV infection, if present.
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...
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
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.
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