The document outlines diagnostic criteria for tuberculosis meningitis (TBM), detailing clinical and laboratory entry criteria including CSF analysis and neuroimaging findings. Key indicators for TBM consist of elevated CSF pressure, lymphocytic pleocytosis, specific protein levels, low glucose concentration, and molecular diagnosis techniques. Radiographic assessments and other tests like the Mantoux test are also mentioned for differentiation from non-TBM conditions.

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