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EXAMINATION FOR
TUBERCULOUS MENINGITIS
Deomampo, John Louis
Serum electrolytes
Urinalysis
Urinalysisis a test that evaluates a sample of your
urine.
Itis used to detect and assess a wide range of
disorders, such as urinary tract infection, kidney disease
and diabetes.
Chest X-ray
An X-ray is an imaging test
that uses small amounts of
radiation to produce pictures
of the organs, tissues, and
bones of the body.
To assess the condition of the
patients lungs
To determine what is causing
the hemoptysis of the patient
CSF EXAMINATION
Lumbar puncture is the cornerstone of diagnosis.
CSF EXAMINATION
CSF leukocyte count:
high leukocyte count (up to 1000/L)
Usually, with a predominance of lymphocytes
Sometimes, predominance of neutrophils in the early stage
CSF glucose:
Low glucose concentration
typically <40 mg/dL but rarely <20 mg/dL.
Protein:
elevated and may be markedly high secondary to hydrocephalus and spinal block.
protein content of 18 g/L (100800 mg/dL)
*However, any of these three parameters can be within the normal range.
AFB MICROSOPY
AFB are seen on direct smear of CSF sediment in up to
one-third of cases, but repeated lumbar punctures
increase the yield.
Examinations or culture of small amounts of CSF are
unlikely to demonstrate M. tuberculosis.
When 5-10 mL of lumbar CSF can be obtained, the acid-fast
stain of the CSF sediment is positive in up to 30% of cases and
the culture is positive in 50-70% of cases.
Methods:
Traditional:
Light microscopy of specimens stained with Ziehl-Neelsen
basic fuschin dyes
-nevertheless satisfactory but time consuming
Modern:
Auramine-rhodamine staining and fluorescence microscopy
-Process large numbers of diagnostic Specimens
IMAGING STUDIES
Radiographic studies can aid in the diagnosis of
tuberculous meningitis.
The advent of CT and MRI has provided insight into
disease progression, and gives prognostic and
diagnostic information.
Both CT and MRI are sensitive to the changes of TBM,
particularly hydrocephalus and basal meningeal
exudates, but they lack specificity.
MRI may provide more diagnostic information than CT
when assessing space occupying lesions.
Early stages:
May be normal
Hydrocephalus
greater in the young, and increases with duration of the illness.
Tuberculoma