A registry of tuberculous meningitis in Hong Kong.
BACKGROUND
A prospective observational study of the presentation, diagnosis, treatment and outcome of tuberculous meningitis (TBM).


METHODS
Demographic characteristics, clinical information, treatment and progress of TBM patients were followed. Their outcomes were ascertained every 6 months for 3 years after diagnosis. Prognostic factors associated with death or full recovery were examined using multivariate Cox's and logistic regression models, respectively.


RESULTS
Between 1993 and 2000, 166 TBM patients were recruited. Their mean age was 42.9, 153 were Chinese and 81 were males; 92% received HRZS (H = isoniazid; R = rifampicin; Z = pyrazinamide; S = streptomycin), HRZE (E = ethambutol) or HRZES. Steroids were given to 105 patients, with no significant effect on outcome. After 3 years of follow-up, 110 patients had completely recovered, 20 survived with disability and 26 died. Death was significantly associated with older age, lower cerebrospinal fluid (CSF) lymphocyte and poorer consciousness levels at the time of presentation, while full recovery was associated with younger age, being female and absence of complications.


CONCLUSIONS
Relatively good outcomes of TBM cases were documented in this Hong Kong study with a case-fatality ratio of 15.7% (26/166) up to 3 years. Early recognition, diagnosis and administration of effective treatment regimens were probably the most important factors in reducing mortality and morbidity.
Lau
K K
KK
Department of Medicine and Geriatrics, Princess Margaret Hospital, Kwai Chung, Hong Kong. dominickklau@yahoo.com.hk
Yu
I T S
IT
Chan
A C K
AC
Wong
L K S
LK
Tam
C M
CM
Sheng
B
B
Li
H L
HL
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000008:administration & dosage*; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D015996:Survival Rate; D016896:Treatment Outcome; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*
D000305:Adrenal Cortex Hormones; D000995:Antitubercular Agents