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The Probert Encyclopaedia of Medicine

TUBERCULOUS MENINGITIS

Tuberculous meningitis is most frequently met with in the second and third years of life, but may affect young adults or older people. The infection is carried to the pia mater by means of the bloodstream from some already existing focus of tuberculous infection, such as tuberculous bone disease, or tuberculous glands in the chest. The onset is usually gradual, with signs of vague and slight illness for several weeks before any definite symptoms appear. The child is noticed to be out of sorts and peevish, and neglects his amusements and play. There is headache and loss of appetite, so that he gradually loses his healthy look and grows paler and thinner. Vomiting is frequent at an early stage of the disease, and usually there is a distinct dislike of light. At a later stage stiffness occurs at the back of the neck, so that the head is pulled backwards on the shoulders - a characteristic sign of irritation of the membranes of the brain. Convulsions are common and a squint may develop.
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