2025 ICD-10-CM code A17.0
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Infectious Disease - Tuberculosis of the nervous system Chapter I: Certain infectious and parasitic diseases (A00-B99) Feed
Tuberculous meningitis is a type of tuberculosis affecting the brain and spinal cord's protective membranes (meninges).
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Medical necessity for treatment of tuberculous meningitis is established by the presence of confirmed *M. tuberculosis* infection in the CSF, consistent clinical symptoms (such as fever, headache, neck stiffness, and neurological deficits), and the potential for severe neurological complications or death without prompt and appropriate treatment.
Diagnosis and treatment of tuberculous meningitis involves various specialists, including infectious disease specialists, neurologists, and neurosurgeons.Responsibilities encompass obtaining a detailed patient history, performing a neurological examination, ordering and interpreting diagnostic tests (CSF analysis, imaging studies), initiating and monitoring anti-tubercular chemotherapy, managing complications, and potentially performing surgical interventions.
In simple words: Tuberculous meningitis is a serious infection of the membranes covering the brain and spinal cord caused by tuberculosis bacteria. Symptoms can include fever, headache, stiff neck, and changes in behavior or mental status.Doctors diagnose it through tests on spinal fluid and imaging scans, treating it with antibiotics and sometimes surgery.
Tuberculous meningitis is a severe form of tuberculosis (TB) affecting the central nervous system.It's caused by *Mycobacterium tuberculosis* infection, leading to inflammation of the meninges surrounding the brain and spinal cord. This can occur even with appropriate anti-tubercular therapy.Clinical presentation involves fever, malaise, anorexia, myalgia, headache, stiff neck, focal neurological deficits, behavioral changes, and altered mental status.Children may experience night sweats, seizures, and gastrointestinal symptoms. Diagnosis relies on positive cerebrospinal fluid (CSF) cultures for *M. tuberculosis*, tuberculin skin tests, and patient history. Imaging studies like MRI or CT scans are also indicated. Treatment includes standard anti-tuberculous chemotherapy (isoniazid, rifampin, rifabutin, pyrazinamide, and ethambutol initially, followed by a longer course of isoniazid, rifabutin, and rifampin).Adjunctive steroid therapy may be used to manage inflammation, and surgery might be necessary in severe cases (hydrocephalus, tuberculomas, abscesses). The condition carries a significant mortality risk.
Example 1: A 35-year-old immunocompromised patient presents with fever, headache, and neck stiffness. CSF analysis reveals *M. tuberculosis*, confirming tuberculous meningitis. Treatment involves a multi-drug regimen, including isoniazid, rifampin, pyrazinamide, and ethambutol., A 10-year-old child with a history of latent TB develops tuberculous meningitis. The child experiences seizures and altered mental status.Treatment involves a combination of anti-tubercular drugs and supportive care, including management of seizures., A 60-year-old patient with a history of treated TB presents with worsening neurological symptoms, including focal weakness and cognitive decline.Imaging shows hydrocephalus. Treatment includes anti-tubercular drugs and surgical intervention to relieve the pressure on the brain.
Comprehensive documentation should include detailed patient history (including TB exposure, symptoms, and prior TB treatment), results of CSF analysis (including bacterial cultures and sensitivity testing), imaging reports (MRI or CT scans of the brain), and a record of the antibiotic regimen. Progress notes should document the patient's response to treatment and any complications encountered.
** Tuberculous meningitis is a life-threatening condition requiring prompt diagnosis and treatment.The prognosis depends on several factors, including the patient's immune status, the severity of the infection, and the effectiveness of treatment.Close monitoring is essential throughout the treatment course.
- Payment Status: Active
- Specialties:Infectious Disease, Neurology, Neurosurgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility