IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Tuberculous meningitis

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Headache. Drowsiness. Post EVD insertion for hydrocephalus on CT brain.

Patient Data

Age: 30 years
Gender: Male
mri

Enhancement and high FLAIR signal in the basal cisterns (best seen at the level of the midbrain and pons) is classical for tuberculous meningitis. Ventricular dilatation is stable and compatible with communicating hydrocephalus secondary to tuberculous meningitis. High FLAIR signal at the vertex is non-specific and can be seen in the setting of meningitis or hyperoxygenation.

Case Discussion

This patient presented with fevers and drowsiness. Initial CT brain demonstrated marked hydrocephalus and the patient was taken for urgent ventricular decompression. Subsequent CSF testing demonstrated tuberculosis meningitis. 

Mycobacterial investigation specimen

Specimen Type: CSF

MICROSCOPY

  • Auramine-Rhodamine Stain: 1-9 Acid Fast Bacilli DETECTED per 100 HPF
  • Ziehl-Neelsen Stain: 1-9 Acid Fast Bacilli DETECTED per 100 HPF

NUCLEIC ACID TESTING (ON SPECIMEN) M. tuberculosis Complex PCR: DETECTED

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.