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Central nervous system tuberculosis (CNS TB) diagnosis relies on clinical features and supportive criteria, not just CSF staining. Early diagnosis via CSF PCR and neuroimaging is recommended over traditional CSF AFB staining and culture.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Central nervous system tuberculosis (CNS TB) presents diagnostic challenges.
  • Tuberculous meningitis (TBM) and tuberculoma are key CNS TB manifestations.

Purpose of the Study:

  • To assess clinical features, complications, and outcomes of CNS TB.
  • To correlate clinical, laboratory, and radiological findings in CNS TB patients.

Main Methods:

  • A cross-sectional study of 50 diagnosed CNS TB cases (TBM or tuberculoma).
  • Data collection included demographics, clinical features, lab findings, treatment, and outcomes.
  • Follow-up occurred during hospitalization and six months post-chemotherapy.

Main Results:

  • 42 patients had TBM, 8 had tuberculoma; mean age 33.5 years, male predominance.
  • Common symptoms: fever (100%), headache (70%), vomiting (64%).
  • CSF PCR positive in 92.85%, CSF ADA >10 U/L in 90.47%. Neuroimaging showed meningeal enhancement (62%) and tuberculomas (8 patients). Mortality was 30%, higher in HIV-positive patients with stage III disease.

Conclusions:

  • CNS TB diagnosis should integrate clinical features with supportive criteria, moving beyond solely CSF staining/culture.
  • Rapid diagnosis using CSF PCR and CT/MRI findings is advocated over CSF AFB staining and culture.