Harsimran Kaur1, Kusum Sharma2, Manish Modi3, Aman Sharma4, Satyawati Rana5, Niranjan Khandelwal6, Sudesh Prabhakar7, Subhash Varma8. 1. Senior Resident, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 2. Associate Professor, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 3. Assistant Professor, Department of Neurology, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 4. Assistant Professor, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 5. Professor, Department of Gastroenterology, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 6. Professor and Head, Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 7. Professor and Head, Department of Neurology, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India . 8. Professor and Head, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research , Sector 12, Chandigarh, India .
Abstract
INTRODUCTION: To assess the clinical profile, laboratory and neuroimaging data of adult tuberculous meningitis (TBM) patients and to determine the predictors of mortality. MATERIALS AND METHODS: A total of 55 TBM patients and 60 controls were enrolled in this prospective study. Detailed clinical, radiological, biochemical and microbiological evaluation was performed. STATISTICAL ANALYSIS: Done using SPSS 15.0 for Windows. P value of <0.05 was considered to be significant. RESULTS: 61.8% were males and majority of the study subjects belonged to age group of 21-40 years. Duration of symptoms in all cases was >14 days and commonly included fever, headache, neck rigidity, altered sensorium and vomiting. Biochemical features of cerebrospinal fluid (CSF) showed significant results where 94.5%, 85.45%,83.63% and 81.81% of patients showed CSF sugar levels <2/3 corresponding blood sugar, proteins>100mg%, CSF total leucocyte count of >20 cells/mm(3) and ADA >9.5IU/L respectively while neuroimaging revealed hydrocephalus, basal exudates and meningeal enhancement as significant findings. More than half of TBM patients presented in stage II of disease and overall mortality was 43.63%. A model for prediction of mortality in TBM cases was framed which included variables of age>40 years, past history of tuberculosis (TB), presence of basal exudates and hydrocephalus. CONCLUSION: TBM is a serious extrapulmonary form of TB and should arise suspicion in mind of clinician based on clinical, laboratory and radiologic results. Further, a model for prediction of mortality in such patients may be helpful for early intervention and better prognosis.
INTRODUCTION: To assess the clinical profile, laboratory and neuroimaging data of adult tuberculous meningitis (TBM) patients and to determine the predictors of mortality. MATERIALS AND METHODS: A total of 55 TBM patients and 60 controls were enrolled in this prospective study. Detailed clinical, radiological, biochemical and microbiological evaluation was performed. STATISTICAL ANALYSIS: Done using SPSS 15.0 for Windows. P value of <0.05 was considered to be significant. RESULTS: 61.8% were males and majority of the study subjects belonged to age group of 21-40 years. Duration of symptoms in all cases was >14 days and commonly included fever, headache, neck rigidity, altered sensorium and vomiting. Biochemical features of cerebrospinal fluid (CSF) showed significant results where 94.5%, 85.45%,83.63% and 81.81% of patients showed CSF sugar levels <2/3 corresponding blood sugar, proteins>100mg%, CSF total leucocyte count of >20 cells/mm(3) and ADA >9.5IU/L respectively while neuroimaging revealed hydrocephalus, basal exudates and meningeal enhancement as significant findings. More than half of TBM patients presented in stage II of disease and overall mortality was 43.63%. A model for prediction of mortality in TBM cases was framed which included variables of age>40 years, past history of tuberculosis (TB), presence of basal exudates and hydrocephalus. CONCLUSION: TBM is a serious extrapulmonary form of TB and should arise suspicion in mind of clinician based on clinical, laboratory and radiologic results. Further, a model for prediction of mortality in such patients may be helpful for early intervention and better prognosis.
Authors: G E Thwaites; T T H Chau; K Stepniewska; N H Phu; L V Chuong; D X Sinh; N J White; C M Parry; J J Farrar Journal: Lancet Date: 2002-10-26 Impact factor: 79.321
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Authors: Prachi R Bapat; Seema D Shekhawat; Aliabbas A Husain; Renuka S Dodkey; Hatim F Daginawala; Lokendra K Singh; Rajpal S Kashyap Journal: Basic Clin Neurosci Date: 2020-09-01