CNS Tuberculosis

Tuberculosis (TB) is the leading single infectious cause of death worldwide. Involvement of the CNS occurs in 1% of all tuberculous infections and accounts for up to 15% of all extrapulmonary TB infections. Whether in the form of tuberculous meningitis (TBM), intracranial tuberculoma, or spinal tuberculosis, establishing the diagnosis is often difficult and relies on a high index of clinical suspicion coupled with access to new, rapid turnaround diagnostic techniques capable of yielding antituberculous drug sensitivities. Tuberculous infection is frequently complicated by coinfection with human immunodeficiency virus (HIV), making diagnosis more difficult. In this chapter, we review clinical presentations, pathology, differential diagnosis and genetic aspects of CNS tuberculosis.