#162 Neurotuberculose | InfectoCast feat. Leonardo Torioni

Central nervous system tuberculosis is among the most severe and challenging forms of the disease. Even when treated, it can lead to high mortality and significant sequelae. In this episode, William Dunke and João Prats welcome infectious disease specialist Leonardo Torioni, a neuroinfectious disease specialist, to discuss the diagnosis, pathophysiology, and management of tuberculous meningitis. The conversation covers the relationship with HIV, the main clinical and laboratory findings, and the diagnostic challenges—from cerebrospinal fluid (CSF) to molecular biology, including imaging, culture, and diagnostic scoring. Therapeutic pillars, the role of corticosteroids, the importance of early treatment initiation, and the limits of the empirical approach in the face of suboptimal test results are also discussed. ▶️ Watch the full episode and deepen your clinical understanding of one of the most complex and fatal manifestations of tuberculosis. Episode References Reference cited at 02:19 GLOBAL BURDEN OF DISEASE STUDY 2019. Global, regional, and national burden of meningitis, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, v. 20, n. 11, p. 918–931, 2021. doi:10.1016/S1474-4422(21)00224-7. Reference cited at 24:15 WORLD HEALTH ORGANIZATION (WHO). Xpert MTB/RIF and Xpert MTB/RIF Ultra tests for the diagnosis of tuberculosis and rifampicin resistance. Geneva: WHO, 2021. Available at: https://www.who.int/publications/i/it.... Reference cited at 33:19 THWAITES, G. E. et al. Diagnostic score for tuberculous meningitis: a systematic individual patient data meta-analysis. Clinical Infectious Diseases, v. 77, n. 8, p. 1172–1184, 2023. doi:10.1093/cid/ciad120. Reference cited at 43:31 TOROK, M. E. et al. Adjunctive dexamethasone in tuberculous meningitis. The New England Journal of Medicine, v. 351, n. 17, p. 1741–1751, 2004. doi:10.1056/NEJMoa040573.