Symptoms:

The symptoms usually begin gradually, and may include:

• Fever
• Listlessness
• Loss of appetite
• Loss of consciousness
• Nausea and vomiting
• Seizures
• Sensitivity to light (photophobia)
• Severe headache
• Stiff neck

Signs and tests:

For any patient with meningitis, it is important to perform a lumbar puncture ("spinal tap"), in which doctors take a sample of spinal fluid (known as cerebrospinal fluid, or CSF) and send it for lab tests.

When the health care provider suspects tuberculosis, there may be a need to get many CSF samples over time to increase the chance of a diagnosis. This may require many lumbar punctures.

The following tests help diagnose tuberculous meningitis:

• Biopsy of the brain or meninges
• CSF culture
• CSF stain
• CSF test of protein, glucose (sugar) level, and lymphocytes
• Polymerase chain reaction (PCR)
• Skin test for tuberculosis (PPD)