GoMed — TBM Clinical Decision Support

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Probable/Definite TBM

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Possible TBM

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Score a new suspected TBM case using the Uniform Case Definition criteria and get an instant diagnostic classification.

Clinical Alerts

TBM mortality rises sharply with treatment delays >24h

Clinical guideline reminder

HIV co-infection may suppress inflammatory CSF findings

Diagnostic caveat

Empirical treatment warranted for Probable TBM cases

Treatment guideline

CSF AFB smear sensitivity is only 10–40% — don't rule out

Diagnostic caveat

Patient Details & Clinical Features

Demographic information and clinical presentation

Known TB Contact or History

Symptom Duration

Symptoms present for >5 days

Symptoms present for ≤5 days

Subacute/chronic onset is a hallmark of TBM

Systemic Features (any of the following)

Weight loss / night sweats / persistent cough >2 weeks

Neurological Features

Altered consciousness (GCS <15, confusion, agitation)

Cranial nerve palsy (III, IV, VI, VII)

Focal neurological deficit (hemiparesis, aphasia — not CN palsy)

Complete all fields for accurate assessment

CSF Analysis

Cerebrospinal fluid findings

Yes — LP performed, results available

No — LP not performed or results pending

Total WBC Count (cells/µL)

Enter total WBC count (cells/µL)

Lymphocyte Predominance

CSF Protein (g/L)

Enter protein level in g/L

CSF/Serum Glucose Ratio

CSF glucose ÷ serum glucose (normal >0.5)

OR Absolute CSF Glucose (mmol/L)

Microbiological Results

CSF AFB smear positive

CSF Mtb culture positive

CSF Mtb PCR / GeneXpert positive

Cerebral Neuroimaging

CT/MRI brain findings

Imaging Available?

Yes — CT/MRI performed

No — imaging not available (score calculated without imaging)

Basal meningeal enhancement (post-contrast)

Tuberculoma (ring-enhancing lesion)

Infarct (cerebral infarction)

Pre-contrast basal hyperdensity

Evidence of TB Elsewhere

Systemic and extra-CNS tuberculosis evidence

Miliary pattern on CXR

Hilar lymphadenopathy or pulmonary infiltrates

CT thorax: lymphadenopathy or infiltrates (no CXR miliary)

Normal / not performed

AFB smear or Mtb culture positive from non-CNS site (sputum, urine, lymph node, etc.)

Positive IGRA (interferon gamma release assay) or TST ≥10mm

Clinical Notes (optional)

Review & Analyze

Confirm all inputs before generating the diagnostic report

Positive Findings

Clinical Recommendations

AI Neurologist Assessment

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Case History

All diagnostic assessments

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Uniform TBM Case Definition (2010)

Marais et al. (2010) — developed to standardize TBM research and improve diagnostic reproducibility globally.

Category	Max Score
Clinical criteria (duration, systemic, neuro)	6
CSF criteria	4
Cerebral imaging	6
Evidence of TB elsewhere	4
Total	20

Classification (without imaging):

Definite TBM: Positive CSF AFB smear, culture, or PCR
Probable TBM: Score ≥10, no alternative diagnosis
Possible TBM: Score 6–9, no alternative diagnosis
Unlikely TBM: Score <6

Classification (with imaging):

Definite TBM: Positive CSF AFB smear, culture, or PCR
Probable TBM: Score ≥12, no alternative diagnosis
Possible TBM: Score 6–11, no alternative diagnosis
Unlikely TBM: Score <6

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