What are the clinical manifestations of tuberculous meningitis?

Generally, tuberculous meningitis is an infectious disease caused by Mycobacterium tuberculosis invading the meninges. Common specific clinical manifestations include fever, headache, vomiting, nuchal rigidity, and disturbances of consciousness. Detailed analysis is as follows:

1. Fever

When Mycobacterium tuberculosis reproduces in the body, it releases toxins that stimulate the immune system to produce an inflammatory response, causing dysfunction of the body's temperature regulation center, thereby resulting in fever. The fever is usually low-grade or moderate and is often accompanied by night sweats.

2. Headache

After the meninges are invaded by pathogens, congestion and edema of the meninges occur, stimulating the pain nerve endings on the meninges. Meanwhile, intracranial pressure may rise due to increased inflammatory exudate, further aggravating the headache.

3. Vomiting

Elevated intracranial pressure can compress gastrointestinal nerves or directly stimulate the vomiting center, leading to gastrointestinal motility disorders and resulting in vomiting. The vomiting is often projectile, unrelated to eating, and consists of gastric contents. In severe cases, bile may be present.

4. Nuchal Rigidity

After the meninges are inflamed, reflexive spasms of the neck muscles occur, restricting neck movement and resulting in nuchal rigidity. Patients lying flat cannot flex their necks easily, have difficulty bringing their chin close to the chest, and feel significant resistance when their heads are passively turned. Some patients may also experience stiffness of the shoulder muscles.

5. Disturbance of Consciousness

As the disease progresses, the inflammation may involve the brain parenchyma, or cerebral blood supply and oxygenation may be insufficient due to persistently elevated intracranial pressure, affecting normal brain function and resulting in disturbances of consciousness.

In addition, patients with tuberculous meningitis may also experience decreased appetite, weight loss, and blurred vision. In daily life, if persistent low-grade fever, headache accompanied by vomiting, or other symptoms occur, prompt medical attention for diagnosis and evaluation is necessary.