The evaluation of 38 patients with tuberculous meningitis
Abstract number: 1134_04_278
Cavuslu S., Oncul O., Karakas A.
In this study, 38 tuberculous meningitis (TbcM) patients were evaluated for symptoms, clinical signs, laboratory findings, therapy and prognosis, retrospectively.
In this study, 38 patients with TbcM were evaluated in GATA Haydarpasa Training Hospital Department of Infectious Diseases between 1992 and 2004. Im the study patients had undergone the following investigations: chest radiographs, Mantoux test, sputum, urine, blood and cerebrospinal fluid smear and culture for acid fast bacilli, Compureterized Tomography scan and serial Magnetic Resonance Imaging (MRI) of the brain. The definitive diagnosis was performed with positive CSF smear, culture for acid fast bacilli, PCR and MRI findings. Probable diagnosis was performed with chest radiographs, manthoux test and other CSF examinations.
In our study, 38 consecutive patients were evaluated. The ages of the patients ranged from 20 to 63 years (mean 23.3 ± 9.6 years). Thirty-five (92.1%) patients were male and three (7.9%) were female. The mean duration of neurological symptoms prior to admission was 35.4 ± 21.9 (7100) days. The most frequent presenting symptoms were headache (97.4%), fever (65.8%) and fatigue (52.6%). The most frequent presenting signs were alterations in consciousness in nine cases, speaking disorders in four cases and convulsion in four cases. The definitive diagnosis was performed in two cases (5.3%) patients with identification of bacilli from cultures, in two patients (5.3%) with polymerase chain reaction and in 16 (42.1%) cases with MRI findings. Antituberculosis therapy was used along 1218 months in all cases. Short-time corticosteroid therapy was given to 13 cases. Sequels developed in six (15.8%) cases. The sequels were paralysis of third cranial nerves in two cases, sixth cranial nerves in two cases, and fifth cranial nerves paralysis in one case. Mortality developed in five (13.2%) patients.
Because untreated TbcM is almost always fatal, it must be evaluated in differantial diagnosis of central nervous system infections.
|Session name:||XXIst ISTH Congress|
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