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Update on tuberculosis of the central nervous system: pathogenesis, diagnosis, and treatment

Guy E Thwaites1, Johan F Schoeman

  • 1Department of Microbiology, Imperial College, South Kensington, London, SW7 2AZ UK. guy.thwaites@btinternet.com

Clinics in Chest Medicine
|November 21, 2009
PubMed

Insights

Tuberculous meningitis (TBM) remains dangerous due to outdated understanding and treatment. This review addresses Mycobacterium tuberculosis

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculous meningitis (TBM) is a severe form of tuberculosis with limited advancements in diagnosis and treatment.
  • Current understanding of TBM pathogenesis relies on historical research from the 1920s.
  • Diagnostic methods for TBM are largely unchanged since the 1880s, and therapeutic progress has been minimal since the 1950s.

Purpose of the Study:

  • To review the current understanding of TBM pathogenesis.
  • To identify optimal strategies for early empiric antituberculosis therapy in suspected TBM cases.
  • To outline best practices for managing tuberculous hydrocephalus.

Main Methods:

  • Literature review focusing on Mycobacterium tuberculosis dissemination to the brain.
  • Analysis of diagnostic criteria for early TBM detection.
  • Evaluation of current management protocols for TBM-associated hydrocephalus.

Main Results:

  • Discusses pathways of Mycobacterium tuberculosis entry into the central nervous system.
  • Highlights challenges and potential improvements in diagnosing TBM.
  • Reviews surgical and medical interventions for hydrocephalus in TBM.

Conclusions:

  • Emphasizes the urgent need for updated research in TBM pathogenesis and diagnostics.
  • Stresses the importance of timely diagnosis and treatment initiation for improved TBM outcomes.
  • Underscores the critical role of managing hydrocephalus in TBM patient care.

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