TB meningitis: symptoms, causes, and treatment

What is TB meningitis?

TB meningitis or tuberculous meningitis is a disease in which bacteria Mycobacterium tuberculosis attacks the meninges lining the brain and spinal nervous system. This TB bacterial infection causes inflammation of the lining of the brain (meningitis).

The infection usually starts with regular tuberculosis that starts in the lungs. The bacteria can then move to other organs through the bloodstream and enter the lining of the meninges and form an abscess or purulent pocket.

Tuberculous meningitis is a disease that develops slowly and gradually. This means, the patient may have been exposed to bacteria for a long time, but new symptoms will appear months or years later.

About 20% of sufferers will experience long-term effects, such as brain damage, epilepsy, paralysis, and hearing loss. About 15-30% of sufferers are even at risk of losing their lives due to this disease.

Fortunately, with proper treatment and medication, this disease can be treated.

How common is TB meningitis?

Currently, there are an estimated 2 million people worldwide who are exposed to the TB bacteria, and 10% of them are likely to suffer from certain diseases or health conditions, including TB meningitis.

TB infections are mostly found in developing countries, such as countries in Africa, Southeast Asia, the East Mediterranean, the West Pacific, Russia, China and South America.

Although this disease can affect adults, the Meningitis Research Foundation said the incidence rate is more common in children under 5 years, especially if TB cases are rife in developing countries.

Tuberculosis meningitis can be treated by controlling the existing risk factors. To find out more information about this disease, you can consult a doctor.

Signs and symptoms of TB meningitis

The signs and symptoms of tuberculous meningitis will usually appear slowly and gradually. Symptoms can get worse after a few weeks.

In some cases, people with TB meningitis may show general symptoms of meningitis such as:

• Headache
• Fever
• Nausea and vomiting
• Photophobia (sensitive to light)
• Confusion
• Often sleepy
• Muscle ache
• Loss of consciousness

In children, the symptoms that appear may tend to be less specific and last for more than 6 days, such as:

• Fever
• Cough
• Nausea and Vomiting
• The body is tired
• Weight loss
• It's easier to fuss

Meanwhile, adult sufferers will experience symptoms that are not much different, such as:

• Fever
• Limp body (malaise)
• Weight loss
• Headaches that get worse within 1-2 weeks
• Gag

However, sometimes people with tuberculous meningitis don't feel the symptoms that are in ordinary meningitis, such as stiff neck, headaches, and photophobia. Each sufferer shows characteristics that are different from each other.

There may be signs and symptoms not listed above. If you have concerns about a symptom, you can immediately consult a doctor.

When should I go to the doctor?

If you have experienced early symptoms, it's a good idea to visit your doctor immediately. When the disease is detected at an early stage, the success rate of treating meningitis is much higher.

In a more severe stage, sufferers may experience more extreme signs and symptoms. When the following symptoms appear, do not delay the time to see a doctor:

• Seizures
• Hearing disorders
• Buildup of fluid in the brain cavity
• Hemiparesis (paralysis on one side of the body)
• Other neurological or neurological disorders

Each sufferer's body shows signs and symptoms that vary.

To get the most appropriate treatment and according to your health condition, have any symptoms checked by your doctor or the nearest health service center.

Causes of TB meningitis

TB meningitis is caused by a bacterial infection M. tuberculosis which enters the body through air contact.

Tuberculosis-causing bacteria that enter the lungs if allowed to spread to other parts of the body. Before attacking other organs of the body, tuberculosis bacteria will spread through the bloodstream.

Described in the 2015 study at British Medical Bulletin, k When the bacteria reach the membranes and tissues of the brain, an abscess called a tubercle forms.

These tubercles can rupture and lead to tuberculous meningitis. The rupture of the tubercles can occur within a short period of time, months, or years after the first exposure to the bacteria.

This condition can cause pressure in the skull, so that damage to brain and nerve tissue can potentially occur.

Risk factors

TB meningitis is a disease that can occur in almost anyone, regardless of age and racial group. However, there are several factors that can increase a person's risk for suffering from this disease.

It is important for you to know that having one or more risk factors does not mean you will definitely be exposed to a disease or health condition.

Risk factors are simply conditions that can increase your chances of suffering from certain diseases or health conditions.

The following are risk factors that can trigger TB meningitis:

• Suffering from HIV / AIDS
• Live or travel to an area with a high incidence of tuberculosis
• Have a bad immune system
• Suffering from diabetes mellitus

Complications

Untreated tuberculous meningitis can be fatal to the sufferer. Some of the complications that occur are potentially life threatening. Complications caused by TB meningitis include:

• Hyponatremia
• Seizures
• Hearing loss
• Hydrocephalus
• Tuberculosis encephalopathy
• Stroke
• Dead

Diagnosis of TB meningitis

In diagnosing, the doctor will perform a thorough physical examination. In addition, the doctor will also ask you about the symptoms you feel, as well as a history of the disease that you have or are currently suffering from.

If your doctor suspects tuberculous meningitis, you will be asked to undergo several additional tests, such as:

• Spinal tap (taking spinal fluid and examined in the laboratory)
• Blood culture test
• Membrane biopsy
• Chest X-ray
• CT scan of the head
• Tuberculosis skin test (PPD)

TB meningitis treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

The sooner you receive meningitis treatment, the better the patient's chances of recovery. Generally, they are advised to stay in the hospital so that doctors can closely monitor the progress of the disease.

The type of treatment will depend on the patient's condition and the severity of TB meningitis. The following are the treatment options available:

1. Antibiotic drugs

The first treatment usually given to treat tuberculous meningitis is antibiotics for tuberculosis bacteria.

TB drugs are generally given in the first 2 months to prevent antibiotic resistance. The following are the kinds of antibiotics that doctors prescribe to treat this disease:

• Rifampicin
• Isoniazid
• Pyrazinamide
• Ethambutol
• Streptomycin

2. Operation

In some cases, for example meningitis which has the potential to result in hydrocephalus, the patient may need a surgical procedure to treat the disease.

The operation aims to suck out the buildup of fluid in the brain, thereby reducing the pressure inside the skull. Two types of surgery that are commonly performed to treat TB meningitis are:

• Ventriculoperitoneal shunt placement
• Endoscopic third ventriculostomy

3. Special treatment for TB meningitis in people with HIV

TB meningitis in HIV patients requires special treatment. This is important because HIV patients are more prone to developing the condition immune reconstitution inflammatory syndrome (IRIS), which is a health condition that can be fatal.

Therefore, giving drugs to treat meningitis must also pay attention to how the drug interacts with HIV-specific antiretroviral drugs (ART).

Prevention of tuberculous meningitis

The most effective way to prevent tuberculous meningitis is vaccination.

In some areas with a high incidence of tuberculosis, there is a Bacillus Calmette-Guerin (BCG) vaccination which can be given to prevent the spread of the disease.

This vaccination is effective in controlling TB infection, especially in children. Apart from giving vaccinations, preventing the spread of TB can also be done by treating people with TB bacteria in their bodies, both active and latent.

If you have any questions, consult your doctor for the best solution to your problem.