Tuberculous Meningoencephalitis

Abstract

Prompt diagnosis of tuberculous meningoencephalitis and application of appropriate therapy are usually decisive in the clinical development of this severe illness. All diagnostically useful parameters have to be investigated at the onset of the illness, since bacteriologic evaluation often produces its results too late or produces no results at all. Analysis of the differential cell count of the CSF is of considerable value. Although there are no unequivocal findings indicating tuberculous meningitis, certain cytologic features reappear consistently and can be regarded as characteristic of the infection [140, 165, 176, 222]. The total cell count seldom exceeds 1,000/mm3, and granulocytes predominate in the first exudative stage of tuberculous meningitis, as is also the case in many other infectious diseases of the CNS. The preponderance of granulocytes decreases more rapidly in tuberculous meningitis than in bacterial meningitis, but more slowly than in the viral form.