Which finding is indicative of tuberculosis meningitis in CSF analysis?

Tuberculosis meningitis (TBM) is a form of meningitis that results from the spread of Mycobacterium tuberculosis to the central nervous system. The characteristic findings in the cerebrospinal fluid (CSF) analysis for TBM typically include:

• A predominance of lymphocytes, which reflects the inflammatory response to the infection. In TBM, the lymphocyte count can be significantly elevated.

• A very high protein concentration, which is a result of increased permeability of the blood-brain barrier and the ongoing inflammatory process.

Normal glucose levels are not characteristic of TBM, as glucose levels are usually low in bacterial infections, including TBM. Low lymphocytes would suggest a different type of meningitis, and normal protein levels are not consistent with the inflammation seen in TBM.

Thus, the combination of high lymphocytes along with very high protein levels serves as a hallmark of TBM, helping differentiate it from other types of meningitis, where the CSF findings would be notably different.