Tuberculous Meningitis: Treatment, Cost and Side Effects

Tuberculous meningitis or TB meningitis is an infection of the meninges which is the system of membranes enveloping the central nervous system. It is a progressive disease that begins in the lungs, accounting for 1-2% of the cases and then it spreads to other parts of the body, especially the brain. People whose living conditions are poor gets TB more often and therefore, it is visible more in developing countries.

The main cause of TB meningitis is the bacteria called Mycobacterium Tuberculosis. The bacterium is usually spread or enters the body through by droplet inhalation that is coughing or sneezing. After it enters the body, the bacteria multiply within the lungs and pass into the bloodstream and travel to other parts of the body. When the bacteria travel to the meninges and brain tissue, small abscesses (tubercles/microtubercles which are basically small pus) are formed. These abscesses burst and cause TB. However, this can happen immediately or after several months of the initial infection. As a result of the abscesses bursting, the pressure within the skull increases, resulting in nerve and brain tissue damage which is often severe.

At least 20% of Tb patients suffer longer-term-after-effects. This generally includes brain damage, epilepsy, and paralysis and hearing loss. However, a person may have the Tb bacteria and not develop an infection. Such Tb is generally referred to as latent Tb and can turn into an active Tb. Also, Tb cannot be spread through kissing or shaking hands, sharing foods or doing sex. The bacterium enters the body only through coughing or sneezing or laughing or singing.

Diagnosis of TB meningitis is difficult as symptoms in the early phase usually are negligible and progresses with time. However, doing a blood test may indicate the presence of a bacteria or an infection of the lungs. A specific test for TB meningitis is lumbar puncture, also known as spinal tap. In this test, they will collect fluid from your spinal column and do an analysis. Additional tests may include biopsy of the meninges, chest x-rays, CT scan and PPD skin test. It should be noted that people suffering from other disease like HIV/AIDS or Diabetes have a greater chance of contracting TB.

The treatment of TB meningitis usually include antibiotics. Doctors advise on starting the treatment process early which helps in better recovery of the patient. Generally you will be admitted to a hospital and monitored closely by doctors to see your response to the drugs given for treatment. A combination of antibiotics will be given that includes isoniazid, rifampicin, pyrazinamide and ethambutol. All the four antibiotics are given for the first two months followed by isoniazid and rifampicin for the next ten months. This combination is given to avoid the risk of antibiotics resistant. For drug resistant TB alternate treatment may be required which generally includes a steroid called prednisolone given in the first few weeks of the treatment.

People with latent TB also require antibiotics to eradicate the bacterium from the body so that it does not turn into active TB meningitis. Moreover, doctors stress the importance of finishing the entire course of the antibiotics even if you start feeling better after a few weeks. Another way of prevention includes a vaccination called BCG that is administered to babies and children to protect them against TB disease in the future.

TB meningitis shows these symptoms of aches, pain, and loss of appetite, tiredness and headaches in the early phase of the disease. As the disease progresses, the symptoms also degenerates and becomes more serious which includes headaches, neck stiffness and dislike of bright lights. Additional symptoms may include fever, vomiting, irritability and lethargy. People showing these symptoms are eligible for the treatment. However, people with latent TB and not showing any symptoms is also eligible for the treatment.

A person not showing any of the symptoms of TB meningitis or suffering from other disease like HIV/AIDS or Diabetes are not eligible for the treatment of TB.

Some of the possible side effects of the antibiotics include fever for 3 or more days, pain in the lower abdomen, itchiness or a rash, nausea and vomiting, yellowish skin and eyes, dark or brown urine, tingling, burning or numbness of the hands and feet, fatigue, easy bruising or bleeding, bloody nose and dizziness. Contact your doctor immediately if you are experiencing any of these side effects. However, there are certain complications of TB that can become life-threatening. They include seizures, hearing loss, and increased pressure in the brain which can cause irreversible and permanent damage to the brain, stroke and even death. Make a careful observation and report any side effects and symptoms to your doctor for a proper diagnosis and treatment.

A TB meningitis treatment will be complete once your blood test shows that the bacterium causing TB is not present in your body. Your post-treatment routine will include following a healthy and active lifestyle. Making certain dietary changes also helps which will include having more vitamin D rich foods to fight off infections in the blood. Try to include more fruits like bananas to give you more energy. Include more healthy fats like almonds and walnuts. Milk, yoghurt and cheese provide essential calcium and probiotics to your body to help you recover and make you strong. Drink plenty of fluids to stay hydrated and eliminate constipation.

Avoid places like hospitals where there is an increased chance of getting infected with TB again. Keep your home well-ventilated and stay at home as much as possible. Also, try and where a mask throughout your treatment process and avoid contact with children, babies and elderly people having weak immune system.

Recovery will depend on the type of treatment you are having and also the type and stage of TB you are having. Generally, it requires a 9 to 12 montrhs for you to recover fully from TB and eradicate the bacteria from your body.

The pricing for the treatment of TB meningitis includes doctoral consultation that can range from Rs.1000 to Rs.2000 and medicinal charges range from Rs.10,000 to Rs.20,000.

Yes, the results are permanent if you follow the full course of the antibiotics. However, even after you are cured of TB, there is a chance of getting infected again from another TB infected person.

TB tuberculosis treatment should include conventional and natural remedies to eliminate the infection from the body. Conventional treatments will include antibiotics but natural remedies can lead to overall improvements in health. Natural remedies will include diffusing lemon and eucalyptus oil for inhaling and adaptogenic herbslike rhodiola and astraglus can be taken three time per day to eradicate the symptoms and improve your health.