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Tuberculosis (Edinb). 2010 Nov;90(6):367-74. doi: 10.1016/ Epub 2010 Sep 28.

HIV-associated tuberculous meningitis--diagnostic and therapeutic challenges.

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  • 1Department of Medicine, GF Jooste Hospital, Manenberg 7764, South Africa.


HIV-associated tuberculous meningitis (TBM) poses significant diagnostic and therapeutic challenges and carries a dismal prognosis. In this review, we present the clinical features and management of HIV-associated TBM, and compare this to disease in HIV-uninfected individuals. Although the clinical presentation, laboratory findings and radiological features of TBM are similar in HIV-infected and HIV-uninfected patients, some important differences exist. HIV-infected patients present more frequently with extra-meningeal tuberculosis and systemic features of HIV infection. In HIV-associated TBM, clinical course and outcome are influenced by profound immunosuppression at presentation, emphasising the need for earlier diagnosis of HIV infection and initiation of antiretroviral treatment.

Copyright © 2010 Elsevier Ltd. All rights reserved.

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