TUBERCULOUS

MENINGITIS
Name:- AKRITI KOLE
Roll no:- 106
 LABORATORY DIAGNOSIS
I. SPECIMEN:-
 COLLECTION: by lumbar puncture in a sterile container under aseptic
conditions.
 When csf is allowed to stand, a fibrin web (cobweb) often develops due
to coagulation of fibrinogen.
 In CSF :
(a) moderate rise in cell count (50-500/cu.mm)
(b) predominant cells are lymphocytes (90%)
 BIOCHEMICAL ANALYSIS:
(a) moderate rise of total proteins (80-120 mg%)
(b) Slightly reduced sugar (30-50 mg%)
I. MICROSCOPY:-
Smear prepared from centrifuged deposit

ZIEHL-NEELSON staining is done

shows
fair no. of lymphocytes + few acid fast bacilli (AFB)
II. CULTURE:-
 Centrifuged deposit of csf:
Inoculated on Lowenstein-jensen (LJ) media
Incubated at 370 C for 6-8 weeks
 Identification of M.tuberculosis depends on colony morphology, ZN
staining from colonies & biochemical reactions
 MODE OF INFECTION
■ HEMATOGENOUS SPREAD from other sites(most
common-lung)
■ MILIARY SPREAD
■ DIRECT SPREAD from adjacent site such as vertebral
body
 CLINICAL FEATURES
• HEADACHE
• MALAISE
• MENTAL CONFUSION
• VOMITING
• NECK RIGIDITY
 COMPLICATIONS
1. Hydrocephalus
2. Nerve root damage
3. Tuberculous encephalitis