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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Tuberculosis Meningitis In The Elderly?

My dad Mr. Nanda Bahadur Chhetri (82 years) is suffering from acute headache, loss of memory, complete loss of energy (over a month), inability to stand on feet, coordination in body movements, trembling of hands and over the last 12 days he has acute burning sensation while passing urine and un-emptiness of bladder. The headache and loss of memory has subsided to a great margin but still he is energyless (unable to stand or even sit down) and his urology problem (burning sensation etc) is persistent. He was treated firstly by neurosurgeon at North Bengal Neuro Centre with diagnosis of cerebral demyelination and after 7 days he was fit to walk and he was discharged. We continued medication (tablets) prescribed by the Doc at home, but slowly he started deteriorating. As advised by a neurosurgeon of Manipal Hosp (a case to be taken care by a neurophysician and not neurosurgeon), we got him admitted at Neotia Getwell Centre at Siliguri, where he has been diagnosed for Chronic Meningitis and undergoing treatment. However, Doc says he is undergoing treatment on clinical suspicion as tuberculosis meningitis. He has gone further weak and improvement is not seen. I am in dilemma what could be the correct diagnosis since as per the doc presently taking care, he is 100% sure of his diagnosis. It implies that earlier diagnosis was wrong, but they made the patient all right after 7 days of treatment. It also implies that now when the medication is on correct diagnosis, the condition seems to deplete. Sir, I am in state of confusion, so I need an expert opinion.
Mon, 13 Jan 2020
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General Surgeon 's  Response
Hello,

* There can be a case of multidrug-resistant tuberculosis or other pathology not detected till today.

* For the particular diagnosis, there requires a culture of cerebral fluid as CSF analysis, MRI brain with or without biopsy in certain cases.

Kindly share your reports with me during follow up conversation , so that better focus can be obtained in depth of management possibilities.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Bhagyesh V. Patel, General Surgeon
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How To Treat Tuberculosis Meningitis In The Elderly?

Hello, * There can be a case of multidrug-resistant tuberculosis or other pathology not detected till today. * For the particular diagnosis, there requires a culture of cerebral fluid as CSF analysis, MRI brain with or without biopsy in certain cases. Kindly share your reports with me during follow up conversation , so that better focus can be obtained in depth of management possibilities. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Bhagyesh V. Patel, General Surgeon