TUBERCULOUS MENINGITIS

Course overview

TUBERCULOUS MENINGITIS (TBM) MANIFESTS EXTRAPULMONARY TUBERCULOSIS CAUSED BY THE SEEDING OF THE MENINGES WITH THE BACILLI OF MYCOBACTERIUM TUBERCULOSIS (MTB). MTB IS FIRST INTRODUCED INTO THE HOST BY DROPLET INHALATION INFECTING THE ALVEOLAR MACROPHAGE. THE PRIMARY INFECTION LOCALIZES IN THE LUNG WITH DISSEMINATION TO THE LYMPH NODES. AT THIS POINT IN THE INFECTIOUS PROCESS, A HIGH DEGREE OF BACTEREMIA CAN SEED THE ENTIRE BODY. IN TUBERCULOUS MENINGITIS, THE MENINGES ARE SEEDED BY MTB AND FORM SUB-EPENDYMAL COLLECTIONS CALLED RICH FOCI. THESE FOCI CAN RUPTURE INTO THE SUBARACHNOID SPACE AND CAUSE AN INTENSE INFLAMMATORY RESPONSE THAT CAUSES MENINGITIS SYMPTOMS. THE EXUDATES CAUSED BY THIS RESPONSE CAN ENCASE CRANIAL NERVES AND CAUSE NERVE PALSIES. THEY CAN ENTRAP BLOOD VESSELS CAUSING VASCULITIS, AND BLOCK CEREBRAL SPINAL FLUID (CSF) FLOW LEADING TO HYDROCEPHALUS. THESE IMMUNE RESPONSES CAN LEAD TO COMPLICATIONS ASSOCIATED WITH TUBERCULOUS MENINGITIS AND CHRONIC SEQUELA IN PATIENTS WHO RECOVER FROM TBM. THIS ACTIVITY REVIEWS EVALUATION, MANAGEMENT, AND CURRENT PUBLIC HEALTH PREVENTATIVE MEASURES TO PREVENT TUBERCULOUS MENINGITIS. THIS ACTIVITY HIGHLIGHTS THE INTERPROFESSIONAL TEAMS INVOLVED IN PREVENTING AND MANAGING THIS GLOBAL HEALTH THREAT.