Tuberculeuze meningitis bij kinderen

Tuberculous meningitis is a severe extrapulmonary form of tuberculosis and occurs especially in young children and adolescents. It is associated with high rates of death and morbidity, particularly when diagnosis is delayed. Early recognition improves outcome. Diagnosis is challenging because tuberculous meningitis has become rare in developed countries, and because of the nonspecific symptoms and the lack of sensitivity of the currently available diagnostic tools. Antituberculous treatment should be initiated on the basis of strong clinical suspicion, cerebrospinal fluid changes (leucocytosis, predominantly lymphocytes, increased protein and low glucose) and neuroimaging abnormalities. Do not wait until proof of infection has been obtained! Treatment should consist of 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol) for 2 months followed by 2 drugs (isoniazid, rifampicin) for at least 10 months. Adjunctive corticosteroids are recommended for all children with tuberculous meningitis. We present a 17 - month - old girl with a severe central nervous system tuberculosis.