Tuberculous meningitis (TBM) is one of the major infectious causes of chronic meningitis worldwide with high mortality and morbidity. It is the early detection and appropriate treatment of TBM that can improve the outcome. Several retrospective and prospective studies have been conducted to predict clinical variables of TBM in childhood. However most of the data is in the pre computed tomography (CT) scan era. Aim: The aim of the present study is to identify the clinical variables helpful in early detection of TBM so that early treatment could be started to improve outcome. Study design: Observational Case analysis. Setting: Tertiary Care teaching hospital. Results: Among 117 patients (age 6 month-16 years) majority (68%) were male mostly between ages 1 and 5 years (69 patients (59%)). All patients who presented in stage I (14) showed improvement during their stay in the ward. When ATT was started early (< 1 month duration of illness), all patients showed improvement. Regarding the outcome of the study 23 patients expired (19.6%) and 94 (80.3%) survived either with complete recovery or with some neurological deficit. Conclusion: Our study shows, fever of more than 2 weeks duration, impaired consciousness high ESR, CSF Pleocytosis with predominant lymphocytes are the factors, when they are present TBM should be considered as number one diagnosis. Stage II and III along with delay in starting specific anti-tuberculous treatment are the factors which determine poor outcome and mortality.
|Number of pages||6|
|Journal||Pakistan Paediatric Journal|
|Publication status||Published - Jun 2008|
- Cranial Computerized Tomography (CT)
- Glassgow Coma Scale (GCS)
- Tuberculous Meningitis