meningeal tuberculosis

Summary

Summary: A form of bacterial meningitis caused by MYCOBACTERIUM TUBERCULOSIS or rarely MYCOBACTERIUM BOVIS. The organism seeds the meninges and forms microtuberculomas which subsequently rupture. The clinical course tends to be subacute, with progressions occurring over a period of several days or longer. Headache and meningeal irritation may be followed by SEIZURES, cranial neuropathies, focal neurologic deficits, somnolence, and eventually COMA. The illness may occur in immunocompetent individuals or as an OPPORTUNISTIC INFECTION in the ACQUIRED IMMUNODEFICIENCY SYNDROME and other immunodeficiency syndromes. (From Adams et al., Principles of Neurology, 6th ed, pp717-9)

Top Publications

  1. Thwaites G, Nguyen D, Nguyen H, Hoang T, Do T, Nguyen T, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004;351:1741-51 pubmed
  2. Shaw J, Pasipanodya J, Gumbo T. Meningeal tuberculosis: high long-term mortality despite standard therapy. Medicine (Baltimore). 2010;89:189-95 pubmed publisher
    ..07% of controls. The long-term outlook in patients with proven tuberculous meningitis adequately treated with current standard tuberculous therapy is bleak. A re-examination of treatment strategies is urgently needed...
  3. Thwaites G, Caws M, Chau T, Dung N, Campbell J, Phu N, et al. Comparison of conventional bacteriology with nucleic acid amplification (amplified mycobacterium direct test) for diagnosis of tuberculous meningitis before and after inception of antituberculosis chemotherapy. J Clin Microbiol. 2004;42:996-1002 pubmed
    ..However, the combination of these methods on serial samples detects more cases. Alternative tests are still urgently required...
  4. Thwaites G, Simmons C, Than Ha Quyen N, Thi Hong Chau T, Phuong Mai P, Thi Dung N, et al. Pathophysiology and prognosis in vietnamese adults with tuberculous meningitis. J Infect Dis. 2003;188:1105-15 pubmed
    ..Death was associated with high initial CSF concentrations of lactate, low numbers of white blood cells, in particular neutrophils, and low CSF glucose levels...
  5. Simmons C, Thwaites G, Quyen N, Chau T, Mai P, Dung N, et al. The clinical benefit of adjunctive dexamethasone in tuberculous meningitis is not associated with measurable attenuation of peripheral or local immune responses. J Immunol. 2005;175:579-90 pubmed
    ..These findings challenge previously held theories of corticosteroid action in this disease. An understanding of how dexamethasone acts in TBM may suggest novel and more effective treatment strategies...
  6. Kashyap R, Kainthla R, Satpute R, Chandak N, Purohit H, Taori G, et al. Demonstration of IgG antibodies to 30 Kd protein antigen in CSF for diagnosis of tuberculous meningitis by antibody-capturing ELISA. Neurol India. 2004;52:359-62 pubmed
    ..A simple and rapid immunological assay method has been developed to demonstrate the presence of IgG antibodies to 30Kd protein antigen (30Kdpa) and culture filtrate protein (CFP) in the CSF of patients with Tuberculous meningitis (TBM)...
  7. Thwaites G, Duc Bang N, Huy Dung N, Thi Quy H, Thi Tuong Oanh D, Thi Cam Thoa N, et al. The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with Tuberculous meningitis. J Infect Dis. 2005;192:2134-41 pubmed
    ..Tuberculous meningitis occurs more commonly in human immunodeficiency virus (HIV)-infected individuals than in HIV-uninfected individuals, but whether HIV infection alters the presentation and outcome of tuberculous meningitis is unknown...
  8. Pai M, Flores L, Pai N, Hubbard A, Riley L, Colford J. Diagnostic accuracy of nucleic acid amplification tests for tuberculous meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2003;3:633-43 pubmed
    ..On current evidence, commercial NAA tests show a potential role in confirming tuberculous meningitis diagnosis, although their overall low sensitivity precludes the use of these tests to rule out tuberculous meningitis with certainty...
  9. Karande S, Gupta V, Kulkarni M, Joshi A, Rele M. Tuberculous meningitis and HIV. Indian J Pediatr. 2005;72:755-60 pubmed
    ..To identify factors associated with HIV-infected status in children admitted with tuberculous meningitis (TBM), and to find out whether HIV co-infection affects in-hospital outcome...

More Information

Publications82

  1. Azuaje C, Fernandez Hidalgo N, Almirante B, Martin Casabona N, Ribera E, Diaz M, et al. [Tuberculous meningitis: a comparative study in relation to concurrent human immunodeficiency virus infection]. Enferm Infecc Microbiol Clin. 2006;24:245-50 pubmed
    ..A comparative study was conducted between adult MT patients with and without concurrent human immunodeficiency virus (HIV) infection...
  2. Lee K, Kim E, Yang W, Ryu H, Cho S, Lee B, et al. Persistent increase of matrix metalloproteinases in cerebrospinal fluid of tuberculous meningitis. J Neurol Sci. 2004;220:73-8 pubmed
    ..Inhibiting the MMPs may be an effective strategy for preventing or reducing the complications in tuberculous meningitis...
  3. Enberg G M, Quezada B M, de Toro V C, Fuenzalida L L. [Tuberculous meningitis in adults: review of 53 cases]. Rev Chilena Infectol. 2006;23:134-9 pubmed
    ..TBM is still a present diagnostic problem, in spite of the new diagnostic methods. A high index of suspicion is required in order to make an early diagnosis...
  4. Kalita J, Misra U, Ranjan P. Predictors of long-term neurological sequelae of tuberculous meningitis: a multivariate analysis. Eur J Neurol. 2007;14:33-7 pubmed
    ..Neurological sequelae at year occurred in 78.5% patients with TBM in the form of cognitive impairment, motor deficit and optic atrophy. Sequelae were common in patients who had focal motor deficit and altered sensorium at admission...
  5. Clark M, Vynnycky E. The use of maximum likelihood methods to estimate the risk of tuberculous infection and disease in a Canadian First Nations population. Int J Epidemiol. 2004;33:477-84 pubmed
    ..The epidemiology of tuberculous infection and disease during the period 1926-2000 in this population was investigated...
  6. Thwaites G, Macmullen Price J, Tran T, Pham P, Nguyen T, Simmons C, et al. Serial MRI to determine the effect of dexamethasone on the cerebral pathology of tuberculous meningitis: an observational study. Lancet Neurol. 2007;6:230-6 pubmed
    ..We aimed to determine the effect of dexamethasone on cerebral MRI changes and their association with intracerebral inflammatory responses and clinical outcome in adults treated for tuberculous meningitis...
  7. Evans D. The use of adjunctive corticosteroids in the treatment of pericardial, pleural and meningeal tuberculosis: do they improve outcome?. Respir Med. 2008;102:793-800 pubmed publisher
    ..Rapid improvements in clinical parameters for pleural effusion were not supported by any lasting improved outcomes for these patients...
  8. Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect. 2009;59:167-87 pubmed publisher
    ..The co-administration of anti-retroviral and anti-tuberculosis drugs should follow guidance issued by the British HIV association (www.bhiva.org)...
  9. Simmons C, Thwaites G, Quyen N, Torok E, Hoang D, Chau T, et al. Pretreatment intracerebral and peripheral blood immune responses in Vietnamese adults with tuberculous meningitis: diagnostic value and relationship to disease severity and outcome. J Immunol. 2006;176:2007-14 pubmed
  10. Thwaites G, Chau T, Farrar J. Improving the bacteriological diagnosis of tuberculous meningitis. J Clin Microbiol. 2004;42:378-9 pubmed
    ..Volume of cerebrospinal fluid, duration of symptoms, cerebrospinal fluid neutrophils, lactate, and glucose were all independently associated with bacteriological confirmation...
  11. Patel V, Padayatchi N, Bhigjee A, Allen J, Bhagwan B, Moodley A, et al. Multidrug-resistant tuberculous meningitis in KwaZulu-Natal, South Africa. Clin Infect Dis. 2004;38:851-6 pubmed
    ..The study highlights the prevalence of MDR-TBM and identifies new challenges in the management of affected patients...
  12. Kashyap R, Kainthla R, Biswas S, Agarwal N, Chandak N, Purohit H, et al. Rapid diagnosis of tuberculous meningitis using the Simple Dot ELISA method. Med Sci Monit. 2003;9:MT123-6 pubmed
    ..Dot Enzyme Linked Immunosorbent assay (Dot ELISA) has been standardized to detect MTB antigens and antibodies against MTB in the CSF of TBM patients...
  13. Hawn T, Dunstan S, Thwaites G, Simmons C, Thuong N, Lan N, et al. A polymorphism in Toll-interleukin 1 receptor domain containing adaptor protein is associated with susceptibility to meningeal tuberculosis. J Infect Dis. 2006;194:1127-1134 pubmed publisher
  14. Kashyap R, Dobos K, Belisle J, Purohit H, Chandak N, Taori G, et al. Demonstration of components of antigen 85 complex in cerebrospinal fluid of tuberculous meningitis patients. Clin Diagn Lab Immunol. 2005;12:752-8 pubmed
    ..Therefore, this finding suggests that this protein can be used as a molecular marker for any type of tuberculous infection. It also provides a more sensitive immunoassay option for the early and confirmatory diagnosis of TBM...
  15. Thwaites G, Caws M, Chau T, D Sa A, Lan N, Huyen M, et al. Relationship between Mycobacterium tuberculosis genotype and the clinical phenotype of pulmonary and meningeal tuberculosis. J Clin Microbiol. 2008;46:1363-8 pubmed publisher
    ..The genotype of M. tuberculosis influenced the presenting features of pulmonary and meningeal tuberculosis. The association between the East Asian/Beijing lineage and disease progression and CSF leukocyte count ..
  16. Sterling T, Martire T, de Almeida A, Ding L, Greenberg D, Moreira L, et al. Immune function in young children with previous pulmonary or miliary/meningeal tuberculosis and impact of BCG vaccination. Pediatrics. 2007;120:e912-21 pubmed
    Children <5 years old are at increased risk of miliary/meningeal tuberculosis, but the immunologic factors that place them at risk are unknown...
  17. Thwaites G, Tran T. Tuberculous meningitis: many questions, too few answers. Lancet Neurol. 2005;4:160-70 pubmed
    ..There are many important unanswered questions about the pathophysiology, diagnosis, and treatment of TM. Here we review the available evidence to answer some of these questions, particularly those on the diagnosis and treatment of TM...
  18. Tsenova L, Ellison E, Harbacheuski R, Moreira A, Kurepina N, Reed M, et al. Virulence of selected Mycobacterium tuberculosis clinical isolates in the rabbit model of meningitis is dependent on phenolic glycolipid produced by the bacilli. J Infect Dis. 2005;192:98-106 pubmed
  19. Mathai A, Radhakrishnan V, Sarada C, George S. Detection of heat stable mycobacterial antigen in cerebrospinal fluid by Dot-Immunobinding assay. Neurol India. 2003;51:52-4 pubmed
    ..Thus development of an alternative laboratory diagnostic test is essential for the early diagnosis and treatment of TBM...
  20. Thwaites G, Lan N, Dung N, Quy H, Oanh D, Thoa N, et al. Effect of antituberculosis drug resistance on response to treatment and outcome in adults with tuberculous meningitis. J Infect Dis. 2005;192:79-88 pubmed
    ..Tuberculous meningitis (TBM) caused by Mycobacterium tuberculosis resistant to 1 or more antituberculosis drugs is an increasingly common clinical problem, although the impact on outcome is uncertain...
  21. Matsuura E, Umehara F, Hashiguchi T, Fujimoto N, Okada Y, Osame M. Marked increase of matrix metalloproteinase 9 in cerebrospinal fluid of patients with fungal or tuberculous meningoencephalitis. J Neurol Sci. 2000;173:45-52 pubmed
    ..Taken together, those data suggest that MMP-9 in CSF may be a useful marker of encephalitogenecity during the course of subacute meningitis...
  22. Hosoglu S, Geyik M, Balik I, Aygen B, Erol S, Aygencel T, et al. Predictors of outcome in patients with tuberculous meningitis. Int J Tuberc Lung Dis. 2002;6:64-70 pubmed
    ..To assess predictors of mortality and neurological sequelae in patients with tuberculous meningitis (TBM)...
  23. Schoeman J, Elshof J, Laubscher J, Janse van Rensburg A, Donald P. The effect of adjuvant steroid treatment on serial cerebrospinal fluid changes in tuberculous meningitis. Ann Trop Paediatr. 2001;21:299-305 pubmed
    ..Knowledge of the different CSF responses during the course of anti-tuberculosis therapy is important in clinical decision-making...
  24. Amitava A, Alarm S, Hussain R. Neuro-ophthalmic features in pediatric tubercular meningoencephalitis. J Pediatr Ophthalmol Strabismus. 2001;38:229-34 pubmed
    ..To examine the neuro-ophthalmic profile in childhood tubercular meningoencephalitis and assess its prognostic importance...
  25. Price N, Farrar J, Tran T, Nguyen T, Tran T, Friedland J. Identification of a matrix-degrading phenotype in human tuberculosis in vitro and in vivo. J Immunol. 2001;166:4223-30 pubmed
    ..In summary, M. tuberculosis-infected monocytic cells develop a matrix-degrading phenotype, which was observed in vivo and relates to clinical signs reflecting cerebral injury in tuberculous meningitis...
  26. Thwaites G, Chau T, Stepniewska K, Phu N, Chuong L, Sinh D, et al. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet. 2002;360:1287-92 pubmed
    ..We aimed to create a simple diagnostic aid for tuberculous meningitis in adults on the basis of clinical and basic laboratory features...
  27. Thwaites G, Chau T, Caws M, Phu N, Chuong L, Sinh D, et al. Isoniazid resistance, mycobacterial genotype and outcome in Vietnamese adults with tuberculous meningitis. Int J Tuberc Lung Dis. 2002;6:865-71 pubmed
    ..Centre for Tropical Diseases, a 500-bed hospital for infectious diseases in Ho Chi Minh City, Vietnam...
  28. Kashyap R, Agarwal N, Chandak N, Taori G, Biswas S, Purohit H, et al. The application of the Mancini technique as a diagnostic test in the CSF of tuberculous meningitis patients. Med Sci Monit. 2002;8:MT95-8 pubmed
    ..To establish a rapid diagnosis, we used Single Radial Immuno-Diffusion (SRID) to detect circulating mycobacterium antigen in the CSF of patients with clinically suspected TBM...
  29. Katti M. Assessment of antibody responses to antigens of Mycobacterium tuberculosis and Cysticercus cellulosae in cerebrospinal fluid of chronic meningitis patients for definitive diagnosis as TBM/NCC by passive hemagglutination and immunoblot assays. FEMS Immunol Med Microbiol. 2002;33:57-61 pubmed
    ..However, findings of this study should alert laboratory personnel especially in endemic areas to be extra careful in interpretation of antibody detection results...
  30. Kalita J, Misra U. Effect of methyl prednisolone on sensory motor functions in tuberculous meningitis. Neurol India. 2001;49:267-71 pubmed
    ..On the contrary, the control group fared significantly better than the MPS group. Initial MEP and SEP abnormalities were however related to 3 months outcome (p<0.01)...
  31. Schutte C. Clinical, cerebrospinal fluid and pathological findings and outcomes in HIV-positive and HIV-negative patients with tuberculous meningitis. Infection. 2001;29:213-7 pubmed
    ..This study aimed to analyze clinical, cerebrospinal fluid (CSF) and pathological findings and outcomes in TB meningitis to evaluate whether HIV infection significantly influences the characteristic findings...
  32. Katrak S, Shembalkar P, Bijwe S, Bhandarkar L. The clinical, radiological and pathological profile of tuberculous meningitis in patients with and without human immunodeficiency virus infection. J Neurol Sci. 2000;181:118-26 pubmed
    ..However, such differences have not been reported in tuberculous meningitis (TBM). Here, we therefore compared the clinical, radiological and pathological features of TBM in patients with and without HIV infection...
  33. Anuradha S, Kaur R, Singh N, Baveja U. Serodiagnosis of extra pulmonary tuberculosis using A-60 antigen. J Commun Dis. 2001;33:12-6 pubmed
    ..7%. To conclude, testing for antimycobacterial antibodies to A-60 antigen is a useful adjunct in the diagnosis of extrapulmonary tuberculosis especially neurotuberculosis...
  34. Araújo Filho S, Maia L, Silva H, Almeida J, Albuquerque L. Mesencephalic tuberculous abcess in a patient with AIDS. Arq Neuropsiquiatr. 2008;66:259-60 pubmed
  35. Caccamo N, Meraviglia S, La Mendola C, Guggino G, Dieli F, Salerno A. Phenotypical and functional analysis of memory and effector human CD8 T cells specific for mycobacterial antigens. J Immunol. 2006;177:1780-5 pubmed
    ..Our study represents the first characterization of Ag-specific memory and effector CD8 T cells during TB and may help to understand the type of immune response that vaccine candidates should stimulate to achieve protection. ..
  36. Manley S, Crooks D, Artingstall L, Buxton N, Appleton R, Riordan A, et al. Diffuse central nervous system protoplasmic astrocytoma. Pediatr Blood Cancer. 2010;54:768-9 pubmed publisher
    ..To our knowledge this case represents the distinct presentation of protoplasmic astrocytoma presenting as extensive diffuse meningeal disease. ..
  37. Celik U, Alabaz D, Yildizdas D, Alhan E, Kocabas E, Ulutan S. Cerebral salt wasting in tuberculous meningitis: treatment with fludrocortisone. Ann Trop Paediatr. 2005;25:297-302 pubmed
    ..Diagnosis was based on hyponatraemia associated with high urinary sodium excretion and inappropriately high urine output in the presence of dehydration. Treatment with fludrocortisone resulted in sodium and fluid homeostasis. ..
  38. Nair P, Kalita J, Kumar S, Misra U. MRI pattern of infarcts in basal ganglia region in patients with tuberculous meningitis. Neuroradiology. 2009;51:221-5 pubmed publisher
    ..66%. For ischemic stroke, the sensitivity of posterior infarct was 75% and specificity 70.83%. TBM patients having infarcts in posterior region should be looked for associated risk factors of ischemic stroke. ..
  39. Caws M, Thwaites G, Dunstan S, Hawn T, Lan N, Thuong N, et al. The influence of host and bacterial genotype on the development of disseminated disease with Mycobacterium tuberculosis. PLoS Pathog. 2008;4:e1000034 pubmed publisher
    ..tuberculosis and pulmonary rather than meningeal tuberculosis (Odds ratio (OR) for causing TBM 0.395, 95% confidence intervals (C.I.) 0.193-0.806, P = 0...
  40. Venkataswamy M, Rafi W, Nagarathna S, Ravi V, Chandramuki A. Comparative evaluation of BACTEC 460TB system and Lowenstein-Jensen medium for the isolation of M. tuberculosis from cerebrospinal fluid samples of tuberculous meningitis patients. Indian J Med Microbiol. 2007;25:236-40 pubmed
    ..tuberculosis, from CSF of TBM patients. Use of a solid medium in conjunction with the BACTEC 12B medium is essential for optimal recovery for M. tuberculosis from CSF specimens. ..
  41. Huttner H, Kollmar R, Hug A, Meisel F, Kress B, Schwab S. Fatal tuberculous meningitis caused by immune restoration disease. J Neurol. 2004;251:1522-3 pubmed
  42. Vaideeswar P, Bavdekar S, Jadhav S, Balan R, Pandit S. Necrotizing adenoviral pneumonia: manifestation of nosocomial infection in pediatric intensive care unit. Indian J Pediatr. 2008;75:1171-4 pubmed publisher
    ..The case serves to remind intensivists to consider this diagnosis so that appropriate therapeutic adjustments and measures to prevent the spread of infection to other critically ill subjects are initiated. ..
  43. Huang S, Chen C, Chiu P, Cheng M, Chiu C, Hsieh K. Tuberculous meningitis complicated with hydrocephalus and cerebral salt wasting syndrome in a three-year-old boy. Pediatr Infect Dis J. 2004;23:884-6 pubmed
  44. Sinha M, Garg R, Anuradha Hk -, Agarwal A, Singh M, Verma R, et al. Vision impairment in tuberculous meningitis: predictors and prognosis. J Neurol Sci. 2010;290:27-32 pubmed publisher
    ..Vision impairment occurred in one-fourth of patients with tuberculous meningitis. Principal causes of vision loss were optochiasmatic arachnoiditis and optochiasmal tuberculoma. Impaired vision predicted death or severe disability. ..
  45. Sengoz G. [Evaluating 82 cases of tuberculous meningitis]. Tuberk Toraks. 2005;53:51-6 pubmed
    ..When suspected, an early diagnosis and early treatment of the disease are the most important factors which effect complication and mortality rates. ..
  46. Roca B, Tornador N, Tornador E. Presentation and outcome of tuberculous meningitis in adults in the province of Castellon, Spain: a retrospective study. Epidemiol Infect. 2008;136:1455-62 pubmed publisher
    ..Tuberculous meningitis is a rare and frequently difficult to recognize disease, which results in significant morbidity and mortality. We found an association of mortality with SIADH and lower level of serum cholesterol. ..
  47. Degefie T. Tuberculous meningitis in a district hospital from Southern Ethiopia. Ethiop Med J. 2003;41:311-8 pubmed
    ..05). Hence health workers who treat children should maintain high index of suspicion at all times and evaluate for TBM. The value of prophylaxis for children who have close contact with infectious cases should be evaluated in Ethiopia. ..
  48. Laktaoui A, Naoumi A, Reda K, Kriet M, Elouarsani A, Khayati A, et al. [Macular tuberculoma and optic neuritis: rare association with tuberculosis meningoencephalitis]. J Fr Ophtalmol. 2009;32:673-8 pubmed publisher
    ..It shows the importance of radiological imaging in the semiological study of orbital and cerebral lesions. ..
  49. Adnams C. Perspectives of intellectual disability in South Africa: epidemiology, policy, services for children and adults. Curr Opin Psychiatry. 2010;23:436-40 pubmed publisher
    ..It is imperative that the information gap in epidemiology and the burden of disability be recognized in order to plan for and meet the needs of those with intellectual disability across the lifespan. ..
  50. Singh D, Sachdev V, Singh A, Sinha S. Response to letter. Endoscopic third ventriculostomy in post-tubercular meningitic hydrocephalus. Minim Invasive Neurosurg. 2007;50:251 pubmed
  51. Iliopoulos A, Kedikoglou S, Laxanis S, Kourouklis S, Katsaros E. A case of tuberculous meningoencephalitis in a patient with Behçet's disease. Clin Rheumatol. 2006;25:121-2 pubmed
  52. Nadkar M, Deore R, Singh R. Tumefactive demyelination. J Assoc Physicians India. 2008;56:901-3 pubmed
    ..This time she presented to us with right hemiparesis and altered sensorium. Diagnosis of tumefactive demyelination was made on the basis of typical MRI findings. Patient showed good response to steroids. ..
  53. Figaji A, Fieggen A, Schoeman J, Peter J. Endoscopic third ventriculostomy in post-tubercular meningitic hydrocephalus. Minim Invasive Neurosurg. 2006;49:60-1 pubmed
  54. Moon S, Son J, Chang W. A case of oculomotor nerve palsy and choroidal tuberculous granuloma associated with tuberculous meningoencephalitis. Korean J Ophthalmol. 2008;22:201-4 pubmed publisher
  55. Sil K, Chatterjee S. Shunting in tuberculous meningitis: a neurosurgeon's nightmare. Childs Nerv Syst. 2008;24:1029-32 pubmed publisher
    ..Endoscopic procedures are rarely, if ever, successful. Ventriculo-peritoneal shunting is fraught with complications like high rate of infection and shunt tube blockage. So there is clearly a need to explore methods of CSF diversion...
  56. Figaji A, Sandler S, Fieggen A, Le Roux P, Peter J, Argent A. Continuous monitoring and intervention for cerebral ischemia in tuberculous meningitis. Pediatr Crit Care Med. 2008;9:e25-30 pubmed publisher
    ..We sought to evaluate our experience with two patients with severe TBM and cerebral oxygenation monitoring...
  57. Thuong N, Dunstan S, Chau T, Thorsson V, Simmons C, Quyen N, et al. Identification of tuberculosis susceptibility genes with human macrophage gene expression profiles. PLoS Pathog. 2008;4:e1000229 pubmed publisher
  58. Baveja C, Gumma V, Jain M, Choudhary M, Talukdar B, Sharma V. Newer methods over the conventional diagnostic tests for tuberculous meningitis: do they really help?. Trop Doct. 2009;39:18-20 pubmed publisher
    ..Both the BACTEC culture and PCR had 100% agreement in the diagnosis of TBM. However, BACTEC culture could be a better diagnostic test as drug sensitivity can also be performed by this method...
  59. Tena Suck M, Collado Ortiz M, Rembao Bojorquez D, Gestista N, Garcia Marquez A. Coexistence between meningioma and tuberculosis: case report. J Neurooncol. 2010;99:289-94 pubmed publisher
    ..In addition, some classic plasma cells, mastocytes, and lymphocytes were also detected. The authors describe the unusual case of coexistence between an occipital meningioma and tuberculosis in the same area that resembled metastasis...
  60. Vinnard C, MacGregor R. Tuberculous meningitis in HIV-infected individuals. Curr HIV/AIDS Rep. 2009;6:139-45 pubmed
    ..Additional treatment considerations for HIV-infected individuals include the timing of initiation of antiretroviral therapy, the potential for drug-drug interactions, and the role of adjunctive corticosteroid therapy...
  61. Sadek M, Yue F, Lee E, Gyenes G, Jones R, Hoffstein V, et al. Clinical and immunologic features of an atypical intracranial mycobacterium avium complex (MAC) infection compared with those of pulmonary MAC infections. Clin Vaccine Immunol. 2008;15:1580-9 pubmed publisher
    ..Further studies delineating the potential role of TNF-alpha in limiting the spread of MAC outside the lung are warranted...
  62. Ruggeri C, Valenzise M, Alosi M, Scibilia G, Wasniewska M. [Tuberculoma complicating tuberculous meningitis: description of one paediatric case]. Minerva Pediatr. 2005;57:329-32 pubmed
    ..We underline how such an event is possible, the need for early neuroradiological evaluation and its favourable course, maintaining adequate antitubercular therapy associated with steroid therapy...
  63. Garcia de Viedma D, Marin M, Andrés S, Lorenzo G, Ruiz Serrano M, Bouza E. Complex clonal features in an mycobacterium tuberculosis infection in a two-year-old child. Pediatr Infect Dis J. 2006;25:457-9 pubmed
    ..One of the MTB isolates was cultured only from respiratory specimens, whereas the other was isolated from extrarespiratory site (central nervous system)...
  64. Green J, Tran C, Farrar J, Nguyen M, Nguyen P, Dinh S, et al. Dexamethasone, cerebrospinal fluid matrix metalloproteinase concentrations and clinical outcomes in tuberculous meningitis. PLoS ONE. 2009;4:e7277 pubmed publisher
    ..Matrix metalloproteinases (MMPs) are important in the immunopathology of many inflammatory CNS diseases thus we hypothesized that that their secretion is important in TBM and might be influenced by dexamethasone...
  65. Kalita J, Misra U, Nair P. Predictors of stroke and its significance in the outcome of tuberculous meningitis. J Stroke Cerebrovasc Dis. 2009;18:251-8 pubmed publisher
    ..We sought to study the frequency and predictors of stroke in tuberculous meningitis (TBM) and its prognostic significance...
  66. el Sayed M, Adeuja A. Intracranial tuberculomas: the Hofuf, Saudi Arabia experience. Afr J Med Med Sci. 2006;35:21-7 pubmed
    ..We suggest that when the presenting symptom is primary generalized tonic clonic seizure, the intracranial Tuberculoma is located in the frontal lobe: a high erythrocyte sedimentation rate (ESR) may indicate multiple Tuberculomas...
  67. Chatterjee S, Saini J, Kesavadas C, Arvinda H, Jolappara M, Gupta A. Differentiation of tubercular infection and metastasis presenting as ring enhancing lesion by diffusion and perfusion magnetic resonance imaging. J Neuroradiol. 2010;37:167-71 pubmed publisher
  68. Lammie G, Hewlett R, Schoeman J, Donald P. Tuberculous cerebrovascular disease: a review. J Infect. 2009;59:156-66 pubmed publisher
    ..Study of the molecular pathogenesis of TBM vasculopathy is in its infancy. This review focuses in particular on pathogenetic aspects of tuberculous cerebrovascular disease, with a view to its future targeted prevention...
  69. Yorsangsukkamol J, Chaiprasert A, Prammananan T, Palittapongarnpim P, Limsoontarakul S, Prayoonwiwat N. Molecular analysis of Mycobacterium tuberculosis from tuberculous meningitis patients in Thailand. Tuberculosis (Edinb). 2009;89:304-9 pubmed publisher
    ..8 years. Beijing isolates from 2001 to 2005 were found in higher percentages than those from 1995 to 2000, but this difference was not significant (p=0.28)...
  70. Andronikou S, Greyling P. Devastating yet treatable complication of tuberculous meningitis: the resistant TB abscess. Childs Nerv Syst. 2009;25:1105-6; discussion 1107, 1109-10 pubmed publisher
    ..Tuberculous abscesses may be resistant to medical treatment and may cause devastating complications...
  71. Cagatay A, Ozsut H, Gulec L, Kucukoglu S, Berk H, Ince N, et al. Tuberculous meningitis in adults--experience from Turkey. Int J Clin Pract. 2004;58:469-73 pubmed
    ..TM is a disease that still often results in residual sequelae, and has a mortality rate ranging between 15 and 51%. Experience of countries such as Turkey where drug-resistant tuberculosis and TM are prevalent is important...
  72. Uchibori A, Miyazaki T, Ariga H, Chiba A. [Interferon-gamma release assay in cerebrospinal fluid of a patient with tuberculous meningitis: a case report]. Rinsho Shinkeigaku. 2009;49:428-31 pubmed
    ..IGRA of CSF in combination with peripheral blood-IGRA could be a useful and rapid method for diagnosing active tuberculosis in the central nervous system...
  73. Przybojewski S, Andronikou S, Wilmshurst J. Objective CT criteria to determine the presence of abnormal basal enhancement in children with suspected tuberculous meningitis. Pediatr Radiol. 2006;36:687-96 pubmed
    ..There are no widely accepted objective criteria to determine the presence of basal enhancement on CT in children with suspected tuberculous meningitis (TBM)...