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Tuberculous meningitis: a 30-year review
Abstract:
Tuberculous meningitis remains an important illness that can be difficult to diagnose in a timely fashion and carries significant morbidity. We present a retrospective review of the cases of tuberculous meningitis diagnosed and treated at a single institution. Fifty-eight cases were identified and stratified according to stage of disease at presentation. Four patients (7%) died; three (5%) developed severe neurological sequelae. Poor outcomes were largely confined to cases presenting in an advanced stage and at the extremes of age. Corticosteroids were administered to 56 patients and may have contributed to the comparatively good outcome in these cases.
Insights
Tuberculous meningitis (TBM) is a serious illness. Early diagnosis and treatment, especially with corticosteroids, improve outcomes, while advanced stages and age extremes worsen prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Tuberculous meningitis (TBM) presents diagnostic challenges and significant patient morbidity.
- Timely diagnosis and effective management are crucial for improving patient outcomes.
Purpose of the Study:
- To review cases of TBM diagnosed and treated at a single institution.
- To identify factors associated with patient outcomes in TBM.
Main Methods:
- Retrospective case review of 58 patients diagnosed with TBM.
- Stratification of cases based on disease stage at presentation.
- Analysis of outcomes, including mortality and neurological sequelae.
Main Results:
- Seven percent of patients died; 5% developed severe neurological sequelae.
- Poor outcomes were predominantly observed in advanced disease stages and at age extremes.
- Corticosteroids were administered to 97% of patients, potentially contributing to favorable outcomes.
Conclusions:
- TBM outcomes are significantly influenced by disease stage and patient age.
- Corticosteroid use may be associated with improved outcomes in TBM.
- Further research into early diagnostic markers and optimal treatment strategies for TBM is warranted.