Tuberculous meningitis across the lifespan.

Tuberculous meningitis (TBM) remains the most lethal form of tuberculosis (TB). Despite significant physiological differences, adults, and children with TBM receive similar treatment and are often grouped together in research. Consequently, differences in TBM characteristics across the lifespan are poorly understood but may be relevant to developing more effective and age-appropriate interventions. In this review we discuss potential age-specific considerations in pathogenesis and pathophysiology, and review literature over the last 5 years to describe clinical characteristics, management, and outcomes across age groups. Children <5 years are vulnerable to TB disease and dissemination due to an immature immune system and the developing brain is highly susceptible to injury associated with neuroinflammation, leading to a greater likelihood of disability that has lifelong impact. Amongst adults, those living with human immunodeficiency virus (HIV) and the elderly are at greatest risk of death, but more research into the frequency of neurocognitive disability is needed.