Computed tomography of tuberculous meningitis in infants and children.

Three cases are used to illustrate the computed tomography (CT) findings of tuberculous meningitis in infants and children. The clinical and laboratory findings of these patients are presented, and the differential diagnosis of viral, bacterial and fungal meningitis is reviewed. Tuberculous meningitis should be suspected, even in the infant or child with a negative tuberculin skin test, when a chronically ill patient presents with the acute signs of meningismus, the cerebrospinal fluid analysis demonstrates a low glucose and monocytosis, and cranial CT shows ventricular enlargement with prominent basal and sylvian fissure enhancement after intravenous contrast medium injection. The ease and safety of serial CT examinations make this procedure the ideal radiological method to follow the patient's course in order to evaluate the response to treatment.