CSF analysis: Elevated csf pressure (30-40cm h20) Appearance clear or xanthochromic Lymphocytic pleocytosis(100-500 cells/mm3) Protein (>40mg/dl),mild hypoglycorrhachia Chloride(>600mg/dl) Low glucose concentration (<2.2mmol/L)

1. Investigations TBM
Periya ganesh G B

2. Diagnostic criteria
• Clinical entry criteria
• Laboratory criteria
AFB – visualised or cultured
Nucleic acid amplification test
• Definite tuberculosis meningitis

3. • CSF Analysis
• Neuroimaging
• Serological test

4. CSF analysis
• Elevated csf pressure (30-40cm h20)
• Appearance clear or xanthochromic
• Lymphocytic pleocytosis(100-500 cells/mm3)
• Protein (>40mg/dl),mild hypoglycorrhachia
• Chloride(>600mg/dl)
• Low glucose concentration (<2.2mmol/L)

5. Cont..,
• Csf adenosine deaminase
range 11.6-13.7(in paediatric TBM)
94.7./. Sensitivity
90.4 ./. Specificity
simple method to differentiate TBM from
non tbm
• Molecular diagnosis

6. Neuroimaging
• CT
Basal meningeal enhancement, infarcts ,hydrocephalus
• MRI
Lesions involving brainstem

7. TB elsewhere
• Chest radiographs
• Lung, lymph node, liver, bone marrow, urine, ascetic fluid,
gastric aspirate
• Mantoux test

8. Thankyou