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Tuberculous meningitis in adults--experience from Turkey
A A Cagatay1, H Ozsut, L Gulec
1Istanbul Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Istanbul, Turkey. atayon@yahoo.com
International Journal of Clinical Practice
|June 23, 2004
Summary
Tuberculous meningitis (TM) often leads to neurological deficits. Prolonged symptoms and female gender are significant predictors of these sequelae, highlighting the need for early treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Tuberculous meningitis (TM) has an unknown annual incidence and high mortality (15-51%).
- Drug-resistant tuberculosis and TM are prevalent in some regions, making clinical experience crucial.
- TM frequently results in significant residual neurological sequelae.
Purpose of the Study:
- To retrospectively evaluate clinical and laboratory findings of tuberculous meningitis patients.
- To identify risk factors associated with neurological sequelae in TM.
- To understand radiological findings in TM patients.
Main Methods:
- Retrospective analysis of 42 patients diagnosed with TM between 1991 and 2002.
- Evaluation of clinical data, laboratory findings, and cranial computerised tomography (CT) scans.
- Statistical analysis to identify significant risk factors for neurological sequelae.
Main Results:
- The study included 28 females and 14 males, with a mean age of 33.9 years.
- Common neurological deficits included hemiparesis (35.7%), cranial nerve palsy (30.9%), and altered consciousness (26.9%).
- Prolonged pre-existing symptoms and female gender were significant risk factors for neurological sequelae (p < 0.01 and p < 0.05).
- Cranial CT revealed pathological findings in most patients, with sulcus effacement being the most common.
Conclusions:
- Prolonged duration of symptoms and female gender predict neurological sequelae in tuberculous meningitis.
- Early identification and prompt anti-tuberculosis therapy are crucial for improving patient outcomes.
- Understanding risk factors and radiological findings aids in managing TM and its complications.