How is CNS TB treated?

Treatment for all forms of CNS tuberculosis should consist of 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol) for 2 months followed by 2 drugs (isoniazid, rifampicin) for at least 10 months.

How is CNS TB diagnosed?

The diagnostic utility of skin testing being positive for CNS tuberculosis varies from 10–20%37 to 50%. The performance of the tuberculin skin test for the diagnosis of tuberculosis varies according to age, vaccination with BCG, nutritional status, HIV infection, and technique of administration39.

How does TB affect the CNS?

Tuberculosis of the Central Nervous System Sub-acute to chronic in tempo (usually lasting more than 5 days), meningoencephalitis presents with fever, headache, and nuchal rigidity. Altered sensorium and cranial nerve involvement are not uncommon. Choroid tubercles may be visualized on fundoscopic examination.

WHO TB meningitis treatment guidelines?

Current WHO guidelines for TBM are based on those developed to treat PTB and suggest treatment with 2 months of rifampicin (RMP), isoniazid (INH), pyrazinamide (PZE) and ethambutol (ETB) followed by up to 10 months of RMP and INH for all patients [7].

What happens when TB reaches the brain?

Tuberculous Meningitis involves the central nervous system. Headaches and behavioral changes may be noticed initially. Fever, headache, a stiff neck, and vomiting may also occur. Symptoms among older children and adults may progress from irritability to confusion, drowsiness, and stupor, possibly leading to coma.

What causes TB in the brain?

Causes. Tuberculous meningitis is caused by Mycobacterium tuberculosis. This is the bacterium that causes tuberculosis (TB). The bacteria spread to the brain and spine from another place in the body, usually the lung.

How long do we treat TB meningitis?

Standard Therapies. Meningitis is usually treated with antibiotic drugs used against the bacteria causing the infection. These may include isoniazid, rifampin, streptomycin, and ethambutol. Treatment should last for at least 9 months to one year.

Why ethambutol is given separately?

Ethambutol should not be used as a sole anti-tuberculosis agent, but should be given with at least one other anti-tuberculosis drug to avoid development of resistant strains.

How do you manage TB meningitis?

Antibiotic Therapy and Adjunctive Corticosteroid Therapy The best antimicrobial agents in the treatment of tuberculous meningitis (TBM) include isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and streptomycin (SM), all of which enter cerebrospinal fluid (CSF) readily in the presence of meningeal inflammation.