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Tuberculous meningitis: a 5-year review

Abstract number: 1135_184

Miftode E.G., Leca D., Teodor A., Scurtu R., Teodor D., Radu M., Luca V.

Objectives:  

To assess the present epidemiology, clinical presentation and outcome of patients with tuberculous meningitis (TBM).

Methods:  

A retrospective study was conducted including 118 cases of tuberculous meningitis hospitalized in the Department of Infectious Diseases Iasi between January 1999 and January 2004.

Results:  

Among the 118 patients with tuberculous meningitis children (5 months–15 years) accounted 29% and elderly (>65 years) – 6% of the cases. Clinical condition at the time of admission was: coma in 13.5% of the cases, other consciousness abnormalities – 50%, cranial-nerve palsies – 18.6%, hemi/monoparesis – 8% of the cases. A history of contact with tuberculosis or prior tuberculosis was documented in 36% and 21% of the cases, respectively. In 60% of the patients antituberculous therapy was initiated in the first day after admission, 23% of patients received adequate treatment in the second day and 12% were treated after 48 hours. In 52% of the cases other location of tuberculosis was revealed: pulmonary TB (42%), lymph nodes (8%), bones and joint (5%), etc. A positive CSF culture result M. tuberculosis was available in 17% of the patients and 12% of patients were smear positive. The CSF albumin level was very high (>3 g/l) in 18% of the patients and glucose level was markedly low (<0.3 g/l) in 47% of the cases. Complications occurred in 49% of the patients: hydrocephalus (15%), tuberculoma (4.2%), hemi/monoparesis (12%), and cranial nerve palsies (18.6%). Ninety-five patients recovered (80%), 10 patients (8%) required neurosurgery procedures for complications of TBM and 13 patients (11%) died.

Conclusions:  

The prognosis was generally poor for patients with CSF glucose level at the time of admission and for those presenting late, with stage 2 and 3 disease even when treatment was begun on the day of admission.

Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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