Learn About Tuberculous Meningitis
Tuberculous meningitis is an infection of the tissues covering the brain and spinal cord (meninges).
Tubercular meningitis; TB meningitis
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.
Tuberculous meningitis is very rare in the United States. Most cases are in people who traveled to the United States from other countries where TB is common.
People who have the following have a higher chance of developing tuberculous meningitis:
- HIV/AIDS
- Drink alcohol in excess
- TB of the lung
- Weakened immune system
The symptoms often start slowly, and may include:
- Fever and chills
- Mental status changes
- Nausea and vomiting
- Sensitivity to light (photophobia)
- Severe headache
- Stiff neck (meningismus)
Other symptoms that can occur with this disease may include:
- Agitation
- Bulging fontanelles (soft spots) in babies
- Decreased consciousness
- Poor feeding or irritability in children
- Unusual posture, with the head and neck arched backward (opisthotonos). This is usually found in infants (less than 3 months old)
You will be given several medicines to fight the TB bacteria. Sometimes, treatment is started even if your provider thinks you have the disease, but testing has not confirmed it yet.
Treatment usually lasts for at least 12 months. Medicines called corticosteroids may also be used.
Northwestern Medical Faculty Foundation
Igor Koralnik is a Neurologist in Chicago, Illinois. Dr. Koralnik and is rated as a Distinguished provider by MediFind in the treatment of Tuberculous Meningitis. His top areas of expertise are Progressive Multifocal Leukoencephalopathy, CACH Syndrome, Encephalitis, Thrombectomy, and Endovascular Embolization. Dr. Koralnik is currently accepting new patients.
Reinout Van Crevel practices in Nijmegen, Netherlands. Van Crevel and is rated as an Elite expert by MediFind in the treatment of Tuberculous Meningitis. Their top areas of expertise are Tuberculous Meningitis, Bacterial Meningitis, Meningitis, and Pulmonary Tuberculosis.
Universitas Padjadjaran
Sofiati Dian practices in Bandung, Indonesia. Dian and is rated as an Elite expert by MediFind in the treatment of Tuberculous Meningitis. Their top areas of expertise are Tuberculous Meningitis, Bacterial Meningitis, Meningitis, and Brain Abscess.
Tuberculous meningitis is life threatening if untreated. Long-term follow-up is needed to detect recurring infections.
Untreated, the disease can cause any of the following:
- Brain damage
- Build-up of fluid between the skull and brain (subdural effusion)
- Hearing loss
- Hydrocephalus (build-up of fluid inside the skull that leads to brain swelling)
- Seizures
- Death
Call 911 or the local emergency number or go to an emergency room if you suspect meningitis in a young child who has the following symptoms:
- Feeding problems
- High-pitched cry
- Irritability
- Persistent unexplained fever
Call the local emergency number if you develop any of the serious symptoms listed above. Meningitis can quickly become a life-threatening illness.
Treating people who have signs of a non-active (dormant) TB infection can prevent its spread. A PPD test and other TB tests can be done to tell if you have this type of infection.
Some countries with a high incidence of TB give people a vaccine called BCG to prevent TB. But, the effectiveness of this vaccine is limited, and it is not usually used in the United States. The BCG vaccine may help prevent severe forms of TB, such as meningitis, in very young children who live in areas where the disease is common.
Summary: Dexamethasone is a corticosteroid which can modulate inflammatory-mediated tissue damage associated with a wide range of infectious diseases. Dexamethasone is routinely used for treatment of tuberculous meningitis and for pneumococcal meningitis in adults. In Coronavirus Disease 2019 (COVID-19) dexamethasone is also effectively preventing immune mediated damage of the lungs. There is also indicati...
Summary: Randomized phase II clinical trial which aims to assess the impact on 3-month mortality and safety of adding adalimumab to standard treatment (anti-tuberculosis drugs and corticosteroids) in HIV patients with tuberculosis meningitis in 3 countries (Brazil, Mozambique, and Zambia).
Published Date: November 10, 2024
Published By: Jatin M. Vyas, MD, PhD, Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Centers for Disease Control and Prevention website. Tuberculosis (TB). www.cdc.gov/tb/index.html. Updated January 17, 2025. Accessed March 13, 2025.
Cruz AT, Starke JR. Tuberculosis. In: Cherry JD, Kaplan SL, Harrison GJ, Steinbach WJ, Hotez PJ, Williams JV, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2025:chap 96.
Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 249.