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Research Paper | Medicine | India | Volume 12 Issue 5, May 2023
Clinical Profile of Tuberculosis Meningitis in a Tertiary Care Hospital
Dr. Mohan M E | Dr. Shivaranjan K P | Dr. Namratha Myneni
Abstract: Background: Tuberculosis (TB) is a major global problem and a public health issue of considerable magnitude. Approximately, eight million new cases of TB and three million deaths are reported annually. In recent times, there has been a resurgence of tuberculosis in both developing and developed countries. Among Extra - pulmonary TB, tuberculous meningitis (TBM) leads to multiple central nervous system (CNS) complications and remains a major health problem. Tuberculous Meningitis (TBM) remains an important cause of morbidity and mortality, especially in the developing world, where it accounts for 7 - 12% of the tuberculosis cases. Materials and Methods: Study Setting: This study was carried out in Dept. of General Medicine in BGS GIMS Source: A total of 70 patients of meningitis who were admitted during the study period were taken as study subjects, who fulfilled the inclusion criteria Type of Study: This is a descriptive and case control study. Inclusion Criteria: 1. All Patients presenting with fever and signs of meningeal irritation 2. Age > 18years Exclusion Criteria: 1. Any intracranial bleed or sub dural hematoma 2. Patients already on ATT Results: Total of 70 patients were included in the study, 30 were TB meningitis, 13 were pyogenic meningitis, 26 were viral meningitis, 1 was fungal meningitis. The age of TB meningitis ranged from 18 to 75 years, with a mean age of 41.8years. In TB meningitis group, male: female ratio was 1: 1. The most common symptom was fever followed by headache, altered sensorium and seizures. All the patients had neck stiffness. Papilledema was seen in 33.3%, cranial nerve palsies in 30%, hemiplegia in 16.7% and 10% of the patients were comatose. Cranial nerve palsies, especially oculomotor nerve palsies and hemiplegia were seen only in TB meningitis patients and not observed in other groups of meningitis. Conclusions: The clinical presentation of TBM is vague with non specific symptoms that are hard to distinguish from other types of meningitis. Nested PCR was found to be more sensitive, as compared to smear microscopy. As false negative results are reported on PCR, PCR alone should not be used as a criterion, It should be supported by clinical, radiological, cytological and other microbiological for guiding the clinicians in the decision making for the appropriate therapy.
Keywords: Adenosine Deaminase, Cerebrospinal Fluid, Cranial Nerve Palsy, Meningitis, Pyogenic, Viral, Tuberculosis, Tbm - Tuberculous Meningitis
Edition: Volume 12 Issue 5, May 2023,
Pages: 2211 - 2214