Importance of Diagnosis & Treatment of TB Meningitis
・Even with effective chemotherapy, mortality rate still 20-50%
・Mortality rate correlate with duration of illness, level of consciousness at time of diagnosis, and degree of meningeal inflammation (no. of inflammatory cells and protein level)
・25-30% of survivors have significant neurologic sequelae
Summary
・In areas with limited diagnostic facilities, difficult to establish definitive diagnosis of pleural and CNS TB
・Suspected TB empyema should always be confirmed work-up of suspected TB pleurisy is more optional
・Because consequences of missing a diagnosis of TB meningitis are serious, suspected TB meningitis should always be worked up, including referral to higher level facility if possible
・Empiric treatment of suspected EPTB is acceptable when diagnostic facilities are limited and there is urgent need to treat, e.g. with more advanced TB meningitis
