Central nervous system tuberculosis and adjuvant corticosteroid therapy.

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Central nervous system tuberculosis (CNS TB) presents diagnostic challenges and significant morbidity/mortality.
• Current diagnostic methods rely on clinical presentation, cerebrospinal fluid analysis, and neuroimaging.
• The role of corticosteroids in improving clinical outcomes for CNS TB remains under investigation.

Purpose of the Study:

• To evaluate the impact of corticosteroid therapy as an adjunct to anti-Koch's treatment in patients with suspected CNS tuberculosis.
• To assess the relationship between disease severity grading and patient outcomes.
• To identify key prognostic factors influencing the outcome of CNS TB.

Main Methods:

• Retrospective study of 13 patients with strong clinical suspicion of CNS TB over a 12-month period.
• Patients were classified based on tuberculous meningitis (TM) severity grades.
• Treatment included standard anti-Koch's therapy with adjuvant corticosteroids; outcomes were assessed.

Main Results:

• The majority of patients (69.23%) presented with Grade II tuberculous meningitis.
• CNS TB was diagnosed as tuberculous meningitis in 53.85% and tuberculoma in 46.15% of cases.
• While 23% of patients died, 77% improved, with 20% achieving complete recovery and 80% experiencing residual neurological deficits.

Conclusions:

• Early detection of CNS TB is a critical determinant of patient prognosis.
• Adjuvant corticosteroid therapy, when initiated promptly alongside anti-Koch's treatment, positively influences patient outcomes.
• Despite treatment, residual neurological deficits remain a significant concern in CNS TB survivors.