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Tuberculous meningitis – clinical and laboratory review of 100 patients

Published online by Cambridge University Press:  19 October 2009

M. E. Kilpatrick ,
N. I. Girgis ,
M. W. Yassin  and
A. A. Abu El Ella
M. E. Kilpatrick
Affiliation:
US Naval Medical Research Unit No. 3 and the Abbassia Fever Hospital, Cairo, Egypt
N. I. Girgis
Affiliation:
US Naval Medical Research Unit No. 3 and the Abbassia Fever Hospital, Cairo, Egypt
M. W. Yassin
Affiliation:
US Naval Medical Research Unit No. 3 and the Abbassia Fever Hospital, Cairo, Egypt
A. A. Abu El Ella
Affiliation:
US Naval Medical Research Unit No. 3 and the Abbassia Fever Hospital, Cairo, Egypt
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In developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).

Type
Research Article
Information
Journal of Hygiene , Volume 96 , Issue 2 , April 1986 , pp. 231 - 238
Copyright
Copyright © Cambridge University Press 1986

References

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