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Updated: Oct 21, 2025
A Retrospective Study on Endoscopic Surgery for the Treatment of Paravertebral Abscess in Spinal Tuberculosis Patients
Published on: October 25, 2024
[Meningeal tuberculosis: cases report years 2005-2017]
Diego Rodríguez1, Alejandra Zapata1, Florencia Molina1
1Hospital Nacional Prof. A. Posadas, Buenos Aires, Argentina.
Background:
Tuberculosis (TB) continues to be a global public health problem; its meningeal form leads to greater lethality and sequelae, particularly if it is associated with HIV / AIDS infection.
Aim:
To describe the demographic characteristics, clinical presentation, laboratory and images of patients with meningeal TB (isolation of Mycobacterium tuberculosis in CSF), analyzing differences between HIV and non-HIV patients.
Methods:
We performed an observational and descriptive study, with retrospective analysis of patients attending at the Dr. Alejandro Posadas Hospital, Buenos Aires, since January 2005 to December 2017.
Results:
Thirty-six patients were analyzed, with 22 women with a median age of 36.5 years. Twenty two patients had HIV coinfection, all in the AIDS stage. The symptom onset time was median 11 days. The predominant ones were fever, altered consciousness and headache. In the cerebrospinal fluid were lymphocitosis, hypoglycorrhachia, hyperproteinorrhachia and high lactic acid, according to previously described findings. Of 34 patients who underwent brain scan, 16 patients had no significant pathological findings. MRI was performed in 16 patients, 9 had vascular disorders. Brain MRI was more sensitive to identify meningeal reinforcement than computerized tomography, vascular disorders, and granulomatous lesions. The median onset of treatment was 1 day, with 72.2% of the total receiving coadjuvants with corticosteroids. Mortality of 27.7% and sequelae in 36.1% were observed. Only 5 patients required neurosurgical intervention.
Conclusion:
Since meningeal TB is a disease with high morbidity and mortality, it is imperative to ensure an early diagnosis in its evolution by incorporating molecular biology and imaging (MRI) into broad clinical use.
Insights
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.
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.
