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Research Article | Volume 13 Issue 11 (Nov, 2023) | Pages 512 - 516
A Study On Clinical and Radiological Profile of Tuberculous Meningitis and Prediction of Prognostic Factors
Under a Creative Commons license
Open Access
Received
Sept. 28, 2023
Revised
Oct. 17, 2023
Accepted
Nov. 8, 2023
Published
Nov. 30, 2023
Abstract

Introduction: Tuberculosis (TB), which is caused by bacteria of the Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a major cause of death worldwide.This disease most often affects the lungs, although other organs are involved in up to one-third of cases.Tuberculous meningitis (TBM) is a non-suppurative inflammatory disease of the dura mater and spinal cord meninges caused by tubercle bacillus. About 5-15% of extrapulmonary tuberculosis involves the nervous system.TBM is a major one of extrapulmonary tuberculosis with involvement of the nervous system and accounts for about 70% of nervous system tuberculosis.Materials and Methods: This is a single centre prospective studywas conducted including the patients who were admitted in Department of General Medicine at Siddhartha Medical College, Vijayawada from November 2022 to October 2023. Patients selected for the study, satisfied all the inclusion and exclusion criteria.Patients attending Medicine OPD, Acute Medical Care are included after satisfying the inclusion criteria and written consent is taken.Initial history was directed towards obtaining the details of duration of the symptoms, night sweats, contact with tuberculosis, seizures, weakness, bowel and bladder disturbances, ear discharge, loss of weight etc.Results:Majority of the patients are in the age group (16-35 yrs) 2nd, 3rd & 4th decades (30 out of 50). Half (50%) of the patients have Glasgow coma scale < 9.25 patients (50%) 16 males, 9 females are in stage III.(Deeply comatose with decerebrate or decorticate posturing, irregular pulse and respiration).Hydrocephalus is the most common finding seen in 56% of cases (All are of communicating variety).Poor functional outcome is seen in 8.33%, 38.46%, 88% of stage I, II & III meningitis respectively.Out of 50 patients CT brain evidence of Hydrocephalus is found in 28 patients.Conclusion:In Tuberculous meningitis duration of illness 3 weeks or more at diagnosis, stage-III meningitis, GCS score less than 9 at admission, presence of focal deficit, and hydrocephalus on neuroimaging are the predictors of poor outcome.Patients can be categorized into high risk and low risk groups depending on the presence or absence of poor prognostic factors.Early diagnosis and prompt initiation of treatment reduces the mortality and morbidity.

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