Meningeal tuberculoma
ICD-10 A17.1 is a billable code used to indicate a diagnosis of meningeal tuberculoma.
Meningeal tuberculoma is a localized form of tuberculosis that affects the meninges, the protective membranes covering the brain and spinal cord. It is characterized by the formation of granulomatous lesions, which can lead to increased intracranial pressure and neurological deficits. The condition typically arises from hematogenous spread of Mycobacterium tuberculosis from a primary site, often the lungs, to the central nervous system. Symptoms may include headache, fever, neck stiffness, and altered mental status. Diagnosis is primarily made through imaging studies such as MRI or CT scans, which reveal the presence of tuberculomas, and confirmed by laboratory tests including PCR for Mycobacterium tuberculosis in cerebrospinal fluid (CSF). Treatment involves a prolonged course of antitubercular therapy, typically including isoniazid, rifampicin, pyrazinamide, and ethambutol, often for a duration of 9 to 12 months. Monitoring for drug resistance is crucial, as multidrug-resistant tuberculosis (MDR-TB) can complicate treatment. Public health implications include the need for contact tracing and isolation procedures to prevent transmission, especially in cases of active pulmonary tuberculosis.
Detailed history of exposure, diagnostic tests, and treatment plans.
Patients presenting with neurological symptoms and a history of tuberculosis.
Need for thorough documentation of treatment response and monitoring for drug resistance.
Neurological assessments, imaging results, and treatment response.
Patients with altered mental status or focal neurological deficits.
Coordination with infectious disease specialists for comprehensive care.
Used to obtain CSF for analysis in suspected cases of meningeal tuberculoma.
Document indication for lumbar puncture, CSF findings, and any complications.
Infectious disease specialists should ensure proper follow-up on CSF results.
Common symptoms include severe headaches, fever, neck stiffness, altered mental status, and focal neurological deficits.
Diagnosis is typically made through imaging studies such as MRI or CT scans, along with laboratory tests including PCR for Mycobacterium tuberculosis in cerebrospinal fluid.
Treatment usually involves a prolonged course of antitubercular therapy for 9 to 12 months, depending on the patient's response and any drug resistance.
