The emergence of multidrug-resistant and extensively drug-resistant tuberculosis (TB) and the advent of acquired immunodeficiency syndrome (AIDS) have complicated the diagnosis and treatment of central nervous system tuberculosis in children. Manifestations of central nervous system (CNS) TB varies from meningeal involvement to compressive myelopathy from vertebral TB. Rapid recognition of tuberculous meningitis (TBM) is essential as delays in initiating treatment are associated with poor outcome. Delayed diagnosis and treatment of TBM heralds’ poor neurological outcomes. The laboratory diagnosis of TBM is hampered by the low yield from CSF and the slow growth of M. tuberculosis. The current schedule of treatment of TBM has undergone a considerable change and is now aimed at the elimination of TB by 2030. In this review, we examine the recent advances in the understanding of TBM, its diagnosis, and the treatment.
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