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Tuberculous Meningitis — SCE Neurology MCQ

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HardCNS InfectionsTuberculous MeningitisSCE Neurology

A 29-year-old has microbiologically confirmed drug-susceptible tuberculous meningitis with a sixth-nerve palsy and basal meningeal enhancement. Which planned regimen best matches NICE guidance?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Four drugs for 2 months, then isoniazid/rifampicin for 10 months, with pyridoxine and a 4–8-week corticosteroid taper

Explanation lettering: D = shown as A · E = shown as D · A = shown as E

A is correct: CNS TB requires 2 months of four-drug therapy followed by 10 months of isoniazid and rifampicin; pyridoxine accompanies isoniazid and an initially high-dose corticosteroid is withdrawn over 4–8 weeks. B is the usual 6-month pulmonary schedule and omits indicated steroid. C omits pyrazinamide. D is inadequate in drugs, duration and steroid taper. E overextends the intensive phase and omits continuation therapy.

Reference: NICE NG33: tuberculosis: https://www.nice.org.uk/guidance/ng33/chapter/Recommendations