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[Tuberculous meningitis: prognostic aspects of 22 microbiologically confirmed cases]
J M Ramos1, J Esteban, M L Fernández-Guerrero
1Servicio de Microbiología Clínica, Fundación Jiménez Díaz, Madrid.
Background:
Tuberculous meningitis continues to be a severe disease difficult to diagnose within a reasonable time carrying a high morbimortality.
Methods:
A retrospective review of cases of microbiologically confirmed tuberculous meningitis diagnosed and treated in the authors' institution is presented.
Results:
From 1974-1993, 22 patients (12 males and 10 females, mean age of 31.5 years; range: 4 months and 77 years) were studied. Eighteen patients (81%) presented extrameningeal tuberculosis. Seven (31.8%) died and 6 (27.3%) presented severe neurologic sequelae. The worst prognosis was observed in patients older than the mean (p = 0.03), worse neurologic situation on admittance (p = 0.03) and hydrocephaly diagnosed by imaging techniques (p = 0.04). Corticoids were administered in 15 patients (68%) without contributing comparatively to better disease prognosis.
Conclusions:
The authors consider that the initiation of specific early treatment in justified while awaiting microbiologic confirmation of the disease.