title: Tuberculous meningitis in a country with a low incidence of tuberculosis: still a serious disease and a diagnostic challenge.
abstract: In order to assess the present epidemiology, clinical presentation and outcome of patients with tuberculous meningitis (Tm), a retrospective study was conducted including 20 Tm patients admitted to a referral department in Denmark between January 1988 and July 2000. The findings were compared to those of a similar survey conducted 12 y earlier. A total of 65% of the patients came from countries with a high endemicity of tuberculosis, compared to only 26% in the previous survey. The overall mortality rate was 20%, with elderly patients with various pre-existing diseases being particularly affected. Neurological sequelae were seen in 50% of patients and seemed to be related to the duration of symptoms and treatment delay. The neurological state on admission and a rapid progression of symptoms seemed to be related to mortality. In 85% of the patients treatment was initiated without a definitive bacteriological diagnosis having been reached. The findings indicate that Tm is a rare but still serious disease, and one that is associated with high mortality and morbidity.
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark.
authors.forename: Christine
authors.initials: C
authors.lastname: Bidstrup
authors.forename: Peter Henrik
authors.initials: PH
authors.lastname: Andersen
authors.forename: Peter
authors.initials: P
authors.lastname: Skinhøj
authors.forename: Ase Bengård
authors.initials: AB
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis; D012307:Risk Factors; D014376:Tuberculosis / Q000453:epidemiology*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality