Culture positive tuberculous meningitis: clinical indicators of poor prognosis

Few studies have evaluated culture positive tuberculous meningitis (TBM) as a group. We evaluated certain clinical factors in culture positive TBM which could be associated with a poorer outcome. Out of 40 consecutive TBM patients seen over a period of 4 years in a tertiary referral hospital, 18 cul...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 1999-09, Vol.101 (3), p.157-160
Main Authors: Tan, Eng-King, Chee, Michael W.L, Chan, Ling-Ling, Lee, Yah-Leng
Format: Article
Language:English
Subjects:
Adolescent
Adult
AIDS/HIV
Analysis of Variance
Antitubercular Agents - therapeutic use
Bacterial diseases
Biological and medical sciences
Child
Culture positive tuberculous meningitis
Female
Human bacterial diseases
Humans
Hydrocephalus - microbiology
Infectious diseases
Male
Medical sciences
Middle Aged
Mycobacterium tuberculosis - isolation & purification
Non-human immunodeficiency virus
Poor prognosis
Prognosis
Treatment Outcome
Tropical medicine
Tuberculosis and atypical mycobacterial infections
Tuberculosis, Meningeal - complications
Tuberculosis, Meningeal - diagnosis
Tuberculosis, Meningeal - drug therapy
Tuberculosis, Meningeal - microbiology
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Summary:Few studies have evaluated culture positive tuberculous meningitis (TBM) as a group. We evaluated certain clinical factors in culture positive TBM which could be associated with a poorer outcome. Out of 40 consecutive TBM patients seen over a period of 4 years in a tertiary referral hospital, 18 culture positive and non-human immunodeficiency virus (HIV) related cases were studied. The mean age was 37.9±14.9 years (range 9–63); five were males and 13 females. None had any associated active chronic medical illness. Patients (44.4%) started on antituberculous treatment within 24 h of admission. Treatment was initiated at a median time of 48 h upon admission in hospital. Univariate analysis revealed a significant correlation between hydrocephalus ( P=0.007) and poor morbidity and mortality. The other clinical factors were not statistically significant: age ( P=0.36); sex ( P=0.49); symptom duration ( P=0.69); BCG vaccination ( P=0.65); cerebral infarct ( P=0.63); extrameningeal spread ( P=1.00); steroids ( P=1.00); time to treatment ( P=0.94) and stage of disease ( P=0.11). Hydrocephalus was the only significant factor predisposing culture positive TBM patients to a poorer outcome. There was also a trend towards a poorer prognosis in those with advanced stage of the disease.
ISSN:0303-8467
1872-6968
DOI:10.1016/S0303-8467(99)00025-6