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Prospective Analysis of 55 Cases of Tuberculosis Meningitis (TBM) in North India
oleh: Harsimran Kaur, Kusum Sharma, Manish Modi, Aman Sharma, Satyawati Rana, Niranjan Khandelwal, Sudesh Prabhakar, Subhash Varma
Format: | Article |
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Diterbitkan: | JCDR Research and Publications Private Limited 2015-01-01 |
Deskripsi
Introduction: To assess the clinical profile, laboratory and neuroimaging data of adult tuberculous meningitis (TBM) patients and to determine the predictors of mortality. Materials and Methods: A total of 55 TBM patients and 60 controls were enrolled in this prospective study. Detailed clinical, radiological, biochemical and microbiological evaluation was performed. Statistical Analysis: Done using SPSS 15.0 for Windows. P value of <0.05 was considered to be significant. Results: 61.8% were males and majority of the study subjects belonged to age group of 21-40 years. Duration of symptoms in all cases was >14 days and commonly included fever, headache, neck rigidity, altered sensorium and vomiting. Biochemical features of cerebrospinal fluid (CSF) showed significant results where 94.5%, 85.45%,83.63% and 81.81% of patients showed CSF sugar levels <2/3 corresponding blood sugar, proteins>100mg%, CSF total leucocyte count of >20 cells/mm3 and ADA >9.5IU/L respectively while neuroimaging revealed hydrocephalus, basal exudates and meningeal enhancement as significant findings. More than half of TBM patients presented in stage II of disease and overall mortality was 43.63%. A model for prediction of mortality in TBM cases was framed which included variables of age>40 years, past history of tuberculosis (TB), presence of basal exudates and hydrocephalus. Conclusion: TBM is a serious extrapulmonary form of TB and should arise suspicion in mind of clinician based on clinical, laboratory and radiologic results. Further, a model for prediction of mortality in such patients may be helpful for early intervention and better prognosis.