Tuberculous meningitis in patients with and without human immunodeficiency virus infection.
OBJECTIVE
To characterize the symptoms, signs, laboratory findings, and outcome of culture-proven meningitis due to Mycobacterium tuberculosis in patients with and without human immunodeficiency virus (HIV) infection.


METHODS
Retrospective chart review.


METHODS
Urban public general hospital in the United States.


METHODS
Fifteen patients with and 16 without HIV infection.


METHODS
Demographics, symptoms, physical exam findings, serum sodium, complete blood cell count, CD4+ cell count, cerebrospinal fluid findings, imaging data, and in-hospital mortality.


RESULTS
Symptoms, signs, chest radiograph appearance, cerebrospinal fluid cell counts and chemistries, and mortality were similar in both groups (p = NS). Median CD4+ cell counts were lower in HIV-infected patients (median 99/mm3, range 7 to 251, versus 384/mm3, range 171 to 724 in those without HIV infection, p = 0.007). Intracerebral mass lesions were more common in the HIV-infected group (60% versus 14% in the uninfected group, p = 0.01), although the presence of a mass did not correlate with focal neurologic deficits, altered level of consciousness, or mortality.


CONCLUSIONS
With the exception of an increased incidence of intracerebral mass lesions in HIV-infected individuals, HIV infection appears to have little impact on the findings and in-hospital mortality of tuberculous meningitis.
Dubé
M P
MP
Department of Medicine, Los Angeles County-University of Southern California Medical Center 90033.
Holtom
P D
PD
Larsen
R A
RA
D017088:AIDS-Related Opportunistic Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality