The Spectrum of Presentation, Diagnosis, and Clinical Outcome of Central Nervous System Tuberculosis: A Case Series in Bangabandhu Sheikh Mujib Medical University
Abstract
SH Siddik, KR Ahmed, S Hasan, Z Tasnim, A Zaman, R Yasmin, MG Sarwar, M Monsur, F Ahmed, R Sulta-na and TS Sumaiya
Bangladesh has the highest prevalence of tuberculosis (TB). Of these, tubercular meningitis is the most common and most dev- astating. The usual course is that of insidious onset and subacute progression. Adults with TBM often present with the classic men- ingitis symptoms of fever, headache, and meningismus (stiff neck) along with focal neurological deficits, behavioral changes, and alterations in consciousness. TBM is prone to rapid deterioration once meningeal symptoms and focal neurological signs supervene, leading to stupor, coma, and death within 5 to 8 weeks [1,2]. Intracerebral tuberculosis is characterized by tuberculoma or tu- berculous brain abscess. Clinical manifestations of tuberculoma or tuberculous brain abscess depend largely on their location, and patients often present with headaches, seizures, papilledema, or other signs of increased intracranial pressure [1,3].