Tuberculosis (TB) is a contagious airborne disease that
typically affects the lungs. TB is caused by a bacterium called Mycobacterium
tuberculosis. The bacterium can travel through the bloodstream if the
TB infection is not treated quickly. It can infect other organs and tissues in
Sometimes, the bacterium will travel to the membranes
surrounding the brain and spinal cord (the meninges). Infection of the meninges
can result in the development of a life-threatening condition known as
meningeal tuberculosis. Meningeal tuberculosis is also known as tubercular
meningitis or TB meningitis.
Are the Risk Factors for Developing Meningeal Tuberculosis?
TB and TB meningitis can develop in children and adults of
all ages. However, people with specific health problems are at greater risk for
developing these conditions.
Risk factors for TB meningitis include having a history of:
- excessive alcohol use
- weakened immune system
- diabetes mellitus
TB meningitis is rarely found in the United States because
of high vaccination rates. In low-income countries, children between birth and
4 years old are most likely to develop this condition.
Are the Symptoms of Meningeal Tuberculosis?
Symptoms of TB meningitis typically appear slowly at first.
They become more severe over a period of weeks. During the early stages of the
infection, symptoms typically include:
- low-grade fever
As the disease progresses, the symptoms will become more
serious. Classic symptoms of meningitis (e.g., stiff neck, headache, light
sensitivity) are not always present. Instead, you may experience the following
- changes in mental status (confusion)
- nausea and vomiting
Is Meningeal Tuberculosis Diagnosed?
Your doctor will perform a physical exam and ask you about
your symptoms and medical history.
Your doctor may order additional tests if they think you
have symptoms of TB meningitis. This may include a lumbar puncture (spinal tap). They’ll collect fluid from your
spinal column and send it to a laboratory for analysis to confirm your
Your doctor may order other tests to evaluate your health,
- biopsy of the meninges
- blood culture
- chest X-ray
- CT scan of the head
- skin test for tuberculosis (PPD)
Complications Are Associated with Meningeal Tuberculosis?
The complications of TB meningitis are significant, and in some
cases life-threatening. They include:
- hearing loss
- increased pressure in the brain (intracranial
- brain damage
Increased pressure in the brain can cause permanent and
irreversible brain damage. Call your doctor right away if you experience vision
changes and headaches at the same time. This is a sign of increased pressure in
Is Meningeal Tuberculosis Treated?
Your doctor may prescribe medications called anti-TB drugs,
These drugs will treat both the TB meningitis and TB
Your doctor may also prescribe systemic steroids. Steroids
will reduce complications associated with the condition. Depending on the
severity of the infection, treatment may last as long as 12 months. In some
cases, you may need to receive treatment in the hospital.
Can Meningeal Tuberculosis Be Prevented?
The best way to prevent TB meningitis is to prevent TB
infections. In communities where TB is common, the Bacillus Calmette-Guérin
(BCG) vaccine can help control the spread of the disease. This vaccine is
effective for controlling TB infections in young children.
Treating people with non-active or dormant TB infections can
also help control the spread of the disease. Non-active or dormant infections
occur when a person tests positive for TB, but doesn’t have any symptoms of the
disease. People with dormant infections are still capable of spreading the
Is the Outlook for Patients with Meningeal Tuberculosis?
Your outlook will depend on the severity of your symptoms
and how quickly you seek treatment. Getting an early diagnosis will enable your
doctor to provide treatment. If treatment is received before complications
develop, the outlook will be good.
Outlook for people that develop brain damage or stroke with
TB meningitis is not as good. Developing increased intracranial pressure is a
strong indication of a poor outlook for a person. Brain damage will be
permanent and will impact health over the long term.
You can develop this infection more than once. Your doctor will
need to monitor you after you’re treated for TB meningitis so they can detect
the infection as early as possible.