Tuberculous meningitis--clinical and laboratory review of 100 patients.
In developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).
D000293:Adolescent; D000328:Adult; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000150:complications; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014390:Tuberculosis, Meningeal / Q000150:complications / Q000382:microbiology*
D002556:Cerebrospinal Fluid Proteins; D005947:Glucose