The diagnosis of TBM is often based on a combination of clinical suspicion, cerebrospinal fluid (CSF) analysis, and radiological imaging. Key diagnostic steps include:
- Lumbar Puncture: CSF analysis typically shows elevated protein, low glucose, and pleocytosis with a predominance of lymphocytes. - Imaging: Brain MRI or CT scans may reveal hydrocephalus, basal meningeal enhancement, or tuberculomas. - Microbiological Tests: Acid-fast bacilli staining, culture, and nucleic acid amplification tests (NAATs) on CSF samples can help confirm the diagnosis. - Tuberculin Skin Test (TST) or Interferon-Gamma Release Assays (IGRAs): These tests can support the diagnosis but are not definitive.
