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Diagnosis

Authoring team

  • the diagnosis of tuberculous meningitis is based on CSF changes on lumbar puncture. These include:
    • a low glucose
    • raised protein
    • a lymphocyte dominant pattern of white blood cells
  • diagnosis is confirmed by:
    • microscopy or culture of the CSF
    • PCR

Note - CSF analysis most closely resembles the CSF analysis of viral meningitis. (2)

Neuroimaging can further aid in the diagnosis. Magnetic resonance imaging has demonstrated superiority to computed tomography scans, as it is of higher quality for assessing the brainstem and spine in detecting TB meningitis. (3)

Reference

  1. NICE. Tuberculosis. NICE guideline NG33. Published January 2016, last updated February 2024
  2. Lee SA et al. A New Scoring System for the Differential Diagnosis between Tuberculous Meningitis and Viral Meningitis. J Korean Med Sci. 2018 Jul 30;33(31):e201
  3. Chen X et al. MRI advances in the imaging diagnosis of tuberculous meningitis: opportunities and innovations. Front Microbiol. 2023;14:1308149

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