Tuberculous meningitis

G. Thwaites*, T. T.H. Chau, N. T.H. Mai, Francis Drobniewski, K. McAdam, J. Farrar

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

212 Citations (Scopus)


Uncertainty and doubt dominate all aspects of tuberculous meningitis (TBM). The variable natural history and accompanying clinical features of TBM hinders the diagnosis. Ziehl-Neelsen staining lacks sensitivity and culture results are often insufficiently timely to aid clinical judgement. New rapid diagnostic methods are incompletely evaluated, and many are not suitable for laboratories in low income countries. The duration of chemotherapy for TBM is unclear and the benefits of adjuvant corticosteroids remain in doubt. The only uncomfortable certainties lie in the fatal consequences of missed diagnoses and delayed treatment. This review will discuss the current uncertainties surrounding TBM. More attention will be given to diagnosis and management, as these areas have a direct bearing on patient outcome.

Original languageEnglish
Pages (from-to)289-299
Number of pages11
JournalJournal of Neurology, Neurosurgery and Psychiatry
Issue number3
Publication statusPublished - Mar 2000

Bibliographical note

Copyright 2011 Elsevier B.V., All rights reserved.


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