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.
To assess the present epidemiology, clinical presentation and outcome of patients with tuberculous meningitis (TBM).
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.
Among the 118 patients with tuberculous meningitis children (5 months15 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.
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 name:||XXIst ISTH Congress|
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