Tuberculosis Meningo-encephalitis in Casablanca, Morocco

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Neuromeningeal tuberculosis is a severe manifestation of Mycobacterium tuberculosis infection.
• Diagnosis is challenging due to varied clinical presentations and non-specific radiological findings, often leading to delayed treatment.

Purpose of the Study:

• To characterize the epidemiological profile of confirmed Tuberculous Meningo-encephalitis.
• To identify predictors of mortality and neurological sequelae in patients with Tuberculous Meningo-encephalitis.

Main Methods:

• A retrospective, descriptive, and analytical study of 90 patients diagnosed with Tuberculous Meningo-encephalitis between 2015 and 2018.
• Statistical analyses, including multivariate logistic regression, were employed to determine factors associated with adverse outcomes.

Main Results:

• The study included 90 patients, with a mean age of 38 years; 58% were male. Low socioeconomic status (90%) and recent tuberculosis contact (13.3%) were significant risk factors.
• Common symptoms included fever (97.4%), headache (70%), and stiff neck (58%). Tuberculous Meningo-encephalitis occurred in 59.9% of cases.
• Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, elevated protein, and low glucose. Mycobacterium tuberculosis was confirmed by culture (85%) and RT-PCR (87.5%).
• Delayed diagnosis, hydrocephalus, and the meningoencephalitis form were independently linked to mortality or neurological sequelae.

Conclusions:

• Tuberculous meningoencephalitis exhibits significant clinical, biological, and radiological diversity.
• Prognosis is strongly influenced by the promptness of diagnosis and initiation of treatment.