Table of ContentsView AllTable of ContentsTypes of MeningitisSymptomsCausesDiagnosisTreatmentPrognosisCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types of Meningitis
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Frequently Asked Questions
Symptoms begin with headaches and changes in the way you act. Afever,stiff neck, and vomiting may follow. More severe symptoms can make you feel confused or drowsy, leading to acoma. Without treatment, this disease can threaten your life.
Treatment involves taking antibiotics, often with corticosteroids. The best results occur when treatment begins early.
This article explains the symptoms, causes, diagnosis, and treatment of this disease.
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Tuberculous meningitis occurs when the bacterium that causes tuberculosis infects the tissue surrounding the brain or spinal cord. While it can affect anyone, the disease most often occurs in countries where there is a high incidence of pulmonary tuberculosis (infection of the lungs). According to the World Health Organization (WHO), tuberculosis is most prevalent in certain countries within Asia and Africa.
What Is Tuberculosis?Tuberculosis is a contagious bacterial infection that is spread through the air when an infected person coughs, sneezes, or speaks. It usually affects the lungs, but can spread to the brain, spine, kidneys, and other parts of the body. Without treatment, tuberculosis can cause death.
What Is Tuberculosis?
Tuberculosis is a contagious bacterial infection that is spread through the air when an infected person coughs, sneezes, or speaks. It usually affects the lungs, but can spread to the brain, spine, kidneys, and other parts of the body. Without treatment, tuberculosis can cause death.
Tuberculous meningitis and other forms of bacterial meningitis are often more serious thanviral meningitis. Bacterial meningitis can pose a grave health threat because it can quickly lead toencephalitis, a swelling of the tissues around the brain. This prevents normal blood flow to and from the brain and can result instroke,paralysis,or even death.
Early Symptoms
Early symptoms of tuberculous meningitis develop gradually. They can last from several days to months before illness presents.
Initial symptoms may be vague and not specific to meningitis, which can prevent a patient from seeking treatment. In the early stages of the disease, the following symptoms may occur:
In younger children, other symptoms can include:
In older children and adults, cognitive symptoms can begin with irritability and worsen to drowsiness and near-unconsciousness.
Advanced Symptoms
Without an accurate diagnosis and proper treatment, tuberculous meningitis can worsen to cause serious life-changing and life-threatening symptoms. At this stage, you may experience the following effects of the disease:
Symptoms of Meningitis
Tuberculous meningitis develops as a rare complication of tuberculosis, especially miliary tuberculosis. Miliary tuberculosis occurs when a large number of tiny spots form in the lungs. It develops in fewer than 2% of all cases of tuberculosis.
Miliary tuberculosis is so named because it causes spots the size of millet, which are the small round seeds found in bird food. The bacteria spread through the bloodstream, infecting other organs in the body. When the bacteria infect the brain and spinal cord, tuberculous meningitis occurs. This can be immediate or develop months or years after the initial infection.
The bacterium that causes tuberculosis is spread through the air when an infected person coughs, sneezes or talks. You have a higher risk of catching tuberculosis if you have acompromised immune system.
Cerebrospinal fluid is examined with aspinal tap, also called a lumbar puncture. This test removes a sample of cerebrospinal fluid. The sample is examined under a microscope to make the diagnosis. In some cases, more than one sample may be needed.
Other diagnostic tests, including a mycobacterial culture or a polymerase chain reaction (PCR) test may be used to confirm the presence ofMycobacterium tuberculosis.
What Is a Spinal Tap?
With a prompt diagnosis and medically supervised treatment and support, tuberculous meningitis can be cured.
Treatment of tuberculous meningitis should begin as soon as a diagnosis is confirmed. To prevent lost treatment time, your healthcare provider may advise you to start a treatment plan even before the results of your spinal tap are received (if they think you have the disease).
Treatment typically involves taking the following antibiotics for two months:
An additional 10 months of rifampin and isoniazid are also required. Depending on your condition, your healthcare provider may also add a corticosteroid such as prednisone to your treatment regimen.
Delays in seeking medical care, diagnosis and the start of treatment contribute to the highmorbidity(frequency at which a disease occurs in a population) and mortality rate (number of deaths) associated with tuberculous meningitis. It is the deadliest form of tuberculosis. The disease has the highest mortality rates in children and those with a coinfection of the more common type of human immunodeficiency virus (HIV-1).
Treatment for Close ContactsIf you have had close contact with a person with tuberculous meningitis or any form of meningitis, you may be eligible forprophylaxis treatment. This involves taking antibiotics to prevent the onset of the disease before it strikes. Contact your healthcare provider as soon as you learn you’ve been exposed to the disease.
Treatment for Close Contacts
If you have had close contact with a person with tuberculous meningitis or any form of meningitis, you may be eligible forprophylaxis treatment. This involves taking antibiotics to prevent the onset of the disease before it strikes. Contact your healthcare provider as soon as you learn you’ve been exposed to the disease.
Treatment for tuberculous meningitis can be frustrating because it typically lasts about a year. Long-term follow-up is needed to detect repeat infections.
If you experience complications like hearing loss, brain damage or learning disabilities as a result of tuberculous meningitis, you may have to learn to adapt to changes in your cognitive and/or physical abilities.
Summary
The disease causes swelling in these membranes, which hinders normal blood flow. This raises your risk of long-term cognitive and physical problems. Without treatment, the disease can be fatal.
Early symptoms, like fever and headaches, may be missed because they are common to many other ailments. This can cause a delay in diagnosis and treatment, which can increase your risk of long-term problems from the disease.
When symptoms point to the disease, a spinal tap is used to confirm a diagnosis. Early treatment with antibiotics gives you the best chance of curing the disease and recovering without problems.
A Word From Verywell
A diagnosis of tuberculous meningitis can be frightening. The disease is a serious condition that can cause life-threatening results without treatment.
If symptoms of tuberculous meningitis occur, seek medical treatment immediately. Symptoms can begin slowly, so it’s important to be aware of subtle changes in your activity levels, appetite, and general wellness.
Getting an early diagnosis and treatment gives you the best chance of curing the disease without complications. Enduring treatment that involves taking medication for 10 months or longer can be challenging. However, following a medically supervised treatment plan can reduce your risk of long-term effects and improve your outcome.
Learn MoreHow Tuberculosis (TB) Is Treated
Tuberculous meningitis is relatively rare in the United States. When it occurs, it usually strikes children between the ages of one to five years. You also have a higher than normal risk of getting the disease if you have a weakened immune system, HIV, or have visited a country with a high incidence of tuberculosis.Learn MoreCauses and Risk Factors of Meningitis
Tuberculous meningitis is relatively rare in the United States. When it occurs, it usually strikes children between the ages of one to five years. You also have a higher than normal risk of getting the disease if you have a weakened immune system, HIV, or have visited a country with a high incidence of tuberculosis.
Learn MoreCauses and Risk Factors of Meningitis
A spinal tap is the best way to diagnose tuberculous meningitis. The test involves extracting a sample of cerebrospinal fluid and examining it for the bacterium that causes the disease. A physical examination, PCR test and mycobacterial culture can also be used to support the diagnosis.Learn MoreWhat Is a Spinal Tap?
A spinal tap is the best way to diagnose tuberculous meningitis. The test involves extracting a sample of cerebrospinal fluid and examining it for the bacterium that causes the disease. A physical examination, PCR test and mycobacterial culture can also be used to support the diagnosis.
Learn MoreWhat Is a Spinal Tap?
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Organization for Rare Diseases.Meningitis, tuberculous.Centers for Disease Control and Prevention.Meningitis.World Health Organization.Tuberculosis (TB).Chin JH. Tuberculous meningitis:Diagnostic and therapeutic challenges.Neurology: Clinical Practice. 2014;4(3):199-205. doi: 10.1212/CPJ.0000000000000023Medline Plus.Tuberculosis.Johns Hopkins Medicine.Bacterial meningitis.Medline Plus.Meningitis - tuberculous.Sharma SK, Mohan A, Sharma A.Challenges in the diagnosis & treatment of miliary tuberculosis.Indian J Med Res. 2012;135(5):703-730.MedlinePlus.Tuberculosis.Davis, A., Meintjes, G. & Wilkinson, R.J.Treatment of tuberculous meningitis and its complications in adults.Curr Treat Options Neurol20, 5 (2018). doi:10.1007/s11940-018-0490-9Seddon JA, Tugume L, Solomons R, Prasad K, Bahr NC; Tuberculous Meningitis International Research Consortium.The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res. 2019 Nov 5;4:167. doi: 10.12688/wellcomeopenres.15535.1
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Organization for Rare Diseases.Meningitis, tuberculous.Centers for Disease Control and Prevention.Meningitis.World Health Organization.Tuberculosis (TB).Chin JH. Tuberculous meningitis:Diagnostic and therapeutic challenges.Neurology: Clinical Practice. 2014;4(3):199-205. doi: 10.1212/CPJ.0000000000000023Medline Plus.Tuberculosis.Johns Hopkins Medicine.Bacterial meningitis.Medline Plus.Meningitis - tuberculous.Sharma SK, Mohan A, Sharma A.Challenges in the diagnosis & treatment of miliary tuberculosis.Indian J Med Res. 2012;135(5):703-730.MedlinePlus.Tuberculosis.Davis, A., Meintjes, G. & Wilkinson, R.J.Treatment of tuberculous meningitis and its complications in adults.Curr Treat Options Neurol20, 5 (2018). doi:10.1007/s11940-018-0490-9Seddon JA, Tugume L, Solomons R, Prasad K, Bahr NC; Tuberculous Meningitis International Research Consortium.The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res. 2019 Nov 5;4:167. doi: 10.12688/wellcomeopenres.15535.1
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Organization for Rare Diseases.Meningitis, tuberculous.Centers for Disease Control and Prevention.Meningitis.World Health Organization.Tuberculosis (TB).Chin JH. Tuberculous meningitis:Diagnostic and therapeutic challenges.Neurology: Clinical Practice. 2014;4(3):199-205. doi: 10.1212/CPJ.0000000000000023Medline Plus.Tuberculosis.Johns Hopkins Medicine.Bacterial meningitis.Medline Plus.Meningitis - tuberculous.Sharma SK, Mohan A, Sharma A.Challenges in the diagnosis & treatment of miliary tuberculosis.Indian J Med Res. 2012;135(5):703-730.MedlinePlus.Tuberculosis.Davis, A., Meintjes, G. & Wilkinson, R.J.Treatment of tuberculous meningitis and its complications in adults.Curr Treat Options Neurol20, 5 (2018). doi:10.1007/s11940-018-0490-9Seddon JA, Tugume L, Solomons R, Prasad K, Bahr NC; Tuberculous Meningitis International Research Consortium.The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res. 2019 Nov 5;4:167. doi: 10.12688/wellcomeopenres.15535.1
National Organization for Rare Diseases.Meningitis, tuberculous.
Centers for Disease Control and Prevention.Meningitis.
World Health Organization.Tuberculosis (TB).
Chin JH. Tuberculous meningitis:Diagnostic and therapeutic challenges.Neurology: Clinical Practice. 2014;4(3):199-205. doi: 10.1212/CPJ.0000000000000023
Medline Plus.Tuberculosis.
Johns Hopkins Medicine.Bacterial meningitis.
Medline Plus.Meningitis - tuberculous.
Sharma SK, Mohan A, Sharma A.Challenges in the diagnosis & treatment of miliary tuberculosis.Indian J Med Res. 2012;135(5):703-730.
MedlinePlus.Tuberculosis.
Davis, A., Meintjes, G. & Wilkinson, R.J.Treatment of tuberculous meningitis and its complications in adults.Curr Treat Options Neurol20, 5 (2018). doi:10.1007/s11940-018-0490-9
Seddon JA, Tugume L, Solomons R, Prasad K, Bahr NC; Tuberculous Meningitis International Research Consortium.The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res. 2019 Nov 5;4:167. doi: 10.12688/wellcomeopenres.15535.1
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