Tuberculous meningitis

Case contributed by Dr Henry Knipe

Presentation

Headache. Drowsiness. Post EVD insertion for hydrocephalus on CT brain.

Patient Data

Age: 30 years
Gender: Male
Modality: MRI

Enhancement and high FLAIR signal in the basal cisterns (best seen at the level of the midbrain and pons) is classical for tuberculous meningitis. Ventricular dilatation is stable and compatible with communicating hydrocephalus secondary to tuberculous meningitis. High FLAIR signal at the vertex is non-specific and can be seen in the setting of meningitis or hyperoxygenation.

Case Discussion

This patient presented with fevers and drowsiness. Initial CT brain demonstrated marked hydrocephalus and the patient was taken for urgent ventricular decompression. Subsequent CSF testing demonstrated tuberculosis meningitis. 

Mycobacterial investigation specimen

Specimen Type: CSF

MICROSCOPY

  • Auramine-Rhodamine Stain: 1-9 Acid Fast Bacilli DETECTED per 100 HPF
  • Ziehl-Neelsen Stain: 1-9 Acid Fast Bacilli DETECTED per 100 HPF

NUCLEIC ACID TESTING (ON SPECIMEN) M. tuberculosis Complex PCR: DETECTED

PlayAdd to Share

Case Information

rID: 47750
Case created: 1st Sep 2016
Last edited: 23rd Nov 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.