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Tuberculous tales: an East London experience
  1. Apeksha M Shah1,
  2. Dominika Raciborska2,
  3. Matthew Stevens1,
  4. Sharmilee Gnanapavan1,
  5. Veronica L C White3,
  6. Benjamin Turner1
  1. 1Department of Neurology, Barts Health NHS Trust, London, UK
  2. 2Barts and the London School of Medicine and Dentistry, London, UK
  3. 3Department of Respiratory Medicine, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Apeksha M Shah, Department of Neurology, Barts Health NHS Trust, London, UK; apeksha.shah{at}


Tuberculous meningitis presents a diagnostic and therapeutic challenge, and considering its long history and increasing global incidence, the evidence base for its treatment is relatively scanty. Many UK neurologists will have little first-hand experience of this deadly condition, and if faced with a patient with possible tuberculous meningitis will find decision making less than straightforward. In parts of East London (UK) the rates of tuberculosis and tuberculous meningitis are among the highest in Western Europe, and so the neurologists and respiratory physicians at the Royal London Hospital have encountered many such patients over the years. We have found experience to be a valuable teacher and so would like to share five cases that illustrate the complexities of diagnosis and management of the disease, and complications of its treatment.

  • tuberculosis
  • infectious diseases
  • microbiology
  • pharmacology
  • CSF

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  • Contributors AMS, DR and MS summarised the case histories and reviewed the literature. AMS wrote the first drafts of the manuscript and prepared the figures. SG, VLCW and BT reviewed and revised the manuscript versions and were the lead clinicians in charge of the patients’ care. BT conceived the idea. All authors revised and approved the final draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Commissioned; externally peer reviewed. This article was reviewed by Nicholas Davies, London, UK.

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  • Editors’ commentary
    Phil E M Smith Geraint N Fuller

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