[Clinical symptomatology, diagnostics, and treatment in patients with tuberculous meningoencephalitis].
BACKGROUND
Tuberculous meningoencephalitis (TBM) is still associated with a high mortality. The relative rareness of TBM in Western European countries and the accompanying heterogeneous and unspecific clinical symptoms often result in a delayed diagnosis.


METHODS
We present six HIV-negative patients (age 37-72 years) with a laboratory-confirmed or clinically probable diagnosis of TBM. The diagnosis could be confirmed in three patients by culture of the cerebrospinal fluid (CSF), in one patient by positive tracheal aspirate culture. In the cases with probable TBM, the diagnosis was confirmed by the combination of clinical symptoms, CSF analysis, and magnetic resonance imaging (MRI).


CONCLUSIONS
The diagnostic and therapeutic problems in TBM are discussed. Moreover, the neurologic complications are presented which developed in all patients during the clinical course despite immediate antituberculous therapy.
Els
Thomas
T
Klinik für Neurologie und klinische Neurophysiologie, Universität Freiburg, Germany. els@nz.ukl.uni-freiburg.de
Serr
Annerose
A
Klisch
Joachim
J
Oehm
Eckard
E
Lücking
Carl Hermann
CH
Kassubek
Jan
J
D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D001921:Brain / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003422:Critical Care; D017809:Fatal Outcome; D018023:HIV Seronegativity; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D013116:Spinal Cord / Q000473:pathology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000628:therapy
D000995:Antitubercular Agents