Wednesday, January 28, 2009

Day # 202 - Presumed TB Meningitis

This was a case of a man from an endemic country with an encephalopathy of several weeks duration and a lumbar puncture with a lymphocytic pleocytosis, elevated protein, low glucose and no organisms on the LP. Viral PCR was also negative as were fungal studies. The presumed diagnosis on clinical grounds was TB meningitis.

A modern era review article including a discussion on the role of nuclear antigen testing is here.

The role of adjunctive dexamethasone in TB meningitis is described in an article from NEJM here.

There is a *great* free resource called the Canadian Tuberculosis Standards available here. This reference text provides a plethora of useful information on tuberculosis and would be a worthy addition to anyone's collection.

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