A Critically Ill Patient With Central Nervous System Tuberculosis and Negative Initial Workup

Adeel S Zubair; Mark Landreneau; Jens Witsch; Robert K Fulbright; Anita Huttner; Kevin N Sheth; David Y Hwang

doi:10.3389/fneur.2020.00430

A Critically Ill Patient With Central Nervous System Tuberculosis and Negative Initial Workup

Front Neurol. 2020 Jun 12:11:430. doi: 10.3389/fneur.2020.00430. eCollection 2020.

Authors

Adeel S Zubair¹, Mark Landreneau², Jens Witsch¹, Robert K Fulbright³, Anita Huttner⁴, Kevin N Sheth^{1

5}, David Y Hwang^{1

5}

Affiliations

¹ Department of Neurology, Yale School of Medicine, New Haven, CT, United States.
² Department of Neurology, Stamford Hospital, Stamford, CT, United States.
³ Department of Radiology, Yale School of Medicine, New Haven, CT, United States.
⁴ Department of Pathology, Yale School of Medicine, New Haven, CT, United States.
⁵ Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven, CT, United States.

Abstract

Empiric anti-tuberculous therapy should not be delayed in patients with a strong clinical suspicion for TB. Because confirmatory TB testing may be difficult to obtain, early and empiric treatment, when there is concern for central nervous system TB, may result in improved outcomes for patients. GeneXpert is currently an area of active research, and the test returns diagnostic results within hours, which would make it the preferred test for investigating TB meningitis.

Keywords: CNS TB; GeneXpert; Meningitis; leptomeningeal enhancement; tuberculosis.

Grants and funding

UL1 TR001863/TR/NCATS NIH HHS/United States