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[Meningeal tuberculosis: cases report years 2005-2017].

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Summary

Meningeal tuberculosis (TB) presents significant mortality and sequelae, especially in HIV-coinfected patients. Early diagnosis using molecular biology and MRI is crucial for better outcomes in this severe form of TB.

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Tuberculosis (TB) remains a global health challenge, with meningeal TB exhibiting high lethality and long-term complications.
  • HIV/AIDS coinfection significantly increases the severity and risk associated with meningeal tuberculosis.

Purpose of the Study:

  • To characterize demographic, clinical, and laboratory features of meningeal TB patients.
  • To compare presentations and outcomes between HIV-coinfected and non-HIV patients with meningeal TB.

Main Methods:

  • Retrospective observational study of 36 patients diagnosed with meningeal TB between 2005 and 2017.
  • Analysis included clinical data, cerebrospinal fluid analysis, and neuroimaging (CT and MRI).

Main Results:

  • 22 of 36 patients had HIV coinfection (all AIDS stage). Common symptoms included fever, altered consciousness, and headache.
  • Cerebrospinal fluid showed lymphocytosis, low glucose, high protein, and elevated lactate. MRI detected meningeal enhancement and vascular disorders more effectively than CT.
  • Mortality was 27.7%, with 36.1% experiencing sequelae. Treatment initiation was rapid, with 72.2% receiving corticosteroids.

Conclusions:

  • Meningeal TB is associated with high morbidity and mortality.
  • Early diagnosis is imperative, necessitating the integration of molecular diagnostics and advanced imaging like MRI into clinical practice.
  • Prompt treatment and management strategies are vital for improving patient outcomes.