Tuberculosis of the central nervous system. Esmail, H. & Cooke, G. S. In Tuberculosis in Clinical Practice, pages 85–95. Springer, Cham, Cham, oct, 2021. Paper doi abstract bibtex Tuberculosis (TB) affecting the central nervous system (CNS) accounts for 1% of presentations and can either manifest as a subacute lymphocytic meningitis or with neurological deficit relating to space-occupying tuberculoma. Of all the forms of TB it has the most unfavourable outcome especially when patients present with a reduced conscious level. Due to its paucibacillary nature CNS TB is difficult to diagnose though the recent development of Xpert MTB/RIF Ultra promises a rapid diagnostic with high sensitivity. It is important to ensure a large volume of CSF (8–10 mL) is taken to improve the likelihood of a microbiological diagnosis. For treatment, the CSF penetration of drugs is important to consider, however, the recommended first-line regimen for drug sensitive CNS disease is typically the same as for other forms of TB though for 12 rather than 6 months. Adjunctive therapy with Dexamethasone has been shown to reduce mortality and should be prescribed in a tapering dose along with anti-tuberculous therapy.
@incollection{Esmail2021,
abstract = {Tuberculosis (TB) affecting the central nervous system (CNS) accounts for 1{\%} of presentations and can either manifest as a subacute lymphocytic meningitis or with neurological deficit relating to space-occupying tuberculoma. Of all the forms of TB it has the most unfavourable outcome especially when patients present with a reduced conscious level. Due to its paucibacillary nature CNS TB is difficult to diagnose though the recent development of Xpert MTB/RIF Ultra promises a rapid diagnostic with high sensitivity. It is important to ensure a large volume of CSF (8–10 mL) is taken to improve the likelihood of a microbiological diagnosis. For treatment, the CSF penetration of drugs is important to consider, however, the recommended first-line regimen for drug sensitive CNS disease is typically the same as for other forms of TB though for 12 rather than 6 months. Adjunctive therapy with Dexamethasone has been shown to reduce mortality and should be prescribed in a tapering dose along with anti-tuberculous therapy.},
address = {Cham},
author = {Esmail, Hanif and Cooke, Graham S.},
booktitle = {Tuberculosis in Clinical Practice},
doi = {10.1007/978-3-030-75509-6_6},
editor = {Kon, O M},
isbn = {978-3-030-75509-6},
keywords = {book{\_}chap},
mendeley-tags = {book{\_}chap},
month = {oct},
pages = {85--95},
publisher = {Springer, Cham},
title = {{Tuberculosis of the central nervous system}},
url = {https://link.springer.com/chapter/10.1007/978-3-030-75509-6{\_}6},
year = {2021}
}
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