TB is usually acquired through inhalation of droplets containing Mycobacterium tuberculosis from affected people, and initially results in a localized lung infection, that spreads to the glands in the chest. From here, it can go to almost any organ in the body, but occasionally finds itself in the layers of tissue surrounding the brain called meninges. When this happens, we refer to the condition as TB Meningitis (TBM). The biggest risk factors for developing TBM are HIV infection and malnutrition (both of which limit the body’s ability to fight infection). The BCG injection babies receive at birth provides some protection against TBM.
Diagnosis can be difficult as the early symptoms of infection are non-specific – fever, headache, nausea, irritability – and may not include neck-stiffness (which is the sign that usually alerts us to meningitis). As the disease becomes more severe, patients can become progressively more confused and may develop signs of nerve damage (eg. strange eye movements, reduced strength in the arms and legs). Ultimately, if left untreated, the patient will slip into coma and ultimately die.
The diagnosis is made by looking for signs of TB infection in the chest, or elsewhere in the body, and by performing a lumbar puncture – where the doctor inserts a needle into the spinal canal in the back and takes some of the fluid surrounding the spine.
Treatment involves a long course (9 months) of anti-TB medication involving at least 4 drugs. Despite this, complications are common, and there is a high chance of death or permanent brain damage.
In South Africa, with a high incidence of both TB and HIV, parents and clinicians need to be aware of this dreadful disease.
TB Meningitis is one of the more severe and devastating consequences of TB infection. Although it is an uncommon complication of TB infection (affecting approximately 1 in 300 people with primary TB infection) it is more common in children than adults, especially in the first 5 years of life. Failure to diagnose the condition can lead to permanent and irreversible brain damage.
TB is usually acquired through inhalation of droplets containing Mycobacterium tuberculosis from affected people, and initially results in a localized lung infection, that spreads to the glands in the chest. From here, it can go to almost any organ in the body, but occasionally finds itself in the layers of tissue surrounding the brain called meninges. When this happens, we refer to the condition as TB Meningitis (TBM). The biggest risk factors for developing TBM are HIV infection and malnutrition (both of which limit the body’s ability to fight infection). The BCG injection babies receive at birth provides some protection against TBM.
Diagnosis can be difficult as the early symptoms of infection are non-specific – fever, headache, nausea, irritability – and may not include neck-stiffness (which is the sign that usually alerts us to meningitis). As the disease becomes more severe, patients can become progressively more confused and may develop signs of nerve damage (eg. strange eye movements, reduced strength in the arms and legs). Ultimately, if left untreated, the patient will slip into coma and ultimately die.
The diagnosis is made by looking for signs of TB infection in the chest, or elsewhere in the body, and by performing a lumbar puncture – where the doctor inserts a needle into the spinal canal in the back and takes some of the fluid surrounding the spine.
Treatment involves a long course (9 months) of anti-TB medication involving at least 4 drugs. Despite this, complications are common, and there is a high chance of death or permanent brain damage.
In South Africa, with a high incidence of both TB and HIV, parents and clinicians need to be aware of this dreadful disease.