Risk Factors Determination for Complication in Adult Tubercular Meningitis Patients (original) (raw)
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2021
Background: Outcome of TBM can be modified by several predictors. Objective: This study was undertaken to evaluate the predictors of outcome of tuberculous meningitis (TBM) at 6 and 9 months. Methodology: This hospital based prospective cohort study was carried out from October, 2016 to September, 2017 (1 year) in the in-patient Department of Neurology at the National Institute of Neurosciences & Hospital (NINS & H), Dhaka, Bangladesh. All the patients with age 18 years or more of both sexes with features of TBM fulfilling the case definition criteria was included as the study population. The outcome was measured at 6 and 9 months by modified Rankin Scale (mRS) with no disability (score=0-1), mild disability (score = 2), moderate disability (score=3-4), severe disability (score=5) and dead (score=6). For statistical analysis outcome was classified as death and survival group. A number of clinical, laboratory and radiological parameters were evaluated initially by univariate and fina...
Journal of Child Neurology, 2019
Background:Children are most vulnerable to tubercular meningitis. Neuroimaging is an important initial investigation in tubercular meningitis.Objective:This study was done to describe the clinical profile, neuroimaging changes, and clinical outcome in children with tubercular meningitis.Methodology:This was an observational cohort study on children with tubercular meningitis, between January 2012 and June 2018. Tubercular meningitis was diagnosed on the basis of clinical criteria, cerebrospinal fluid analysis, neuroimaging, and response to antitubercular drug treatment. Preferably magnetic resonance imaging (MRI) with contrast was done.Result:Out of 79 pediatric patients, 17 patients were lost during follow-up; thus, a total of 62 patients were studied. Mean age at presentation was 7.040 (±3.99 SD) year, 51.6% children were male. Rural children were more affected. Twenty eight (45.2 patients had contact with a person with tuberculosis. Only 3 (4.8%) patients presented within 10 days...
JPMA. The Journal of the Pakistan Medical Association, 2013
To assess the clinical course, complications and predictors of mortality in reducing the consequent morbidity and mortality in patients with tuberculous meningitis. A prospective study was carried out at Civil Hospital Karachi from January 2009 to January 2011. Fifty-two confirmed cases of tuberculous meningitis were included. The entire clinical course with complications and predictors of mortality were assessed. Data was analyzed using SPSS version 17.0. The mean age of the patients was 36.29 +/- 16.7 years with an equal gender distribution. The presenting complaints were fever 51 (98.1%), neck-stiffness 44 (84.61%), and altered level of consciousness 40 (76.9%), headache 31 (59.6%), vomiting 19 (36.5%) and focal weakness 10 (19.2%). Among CNS signs, 47 (90.4%) patients had signs of meningeal irritation, 14 (26.9%) had cranial nerve palsies with abducent nerve being the most commonly involved cranial nerve (25%). Mean GCS was 11.4 +/- 2.9 and most of the patients presented with me...
PAFMJ, 2021
Objective: To assess the clinical profile and outcome of patients admitted with the diagnosis of tuberculous meningitis (TBM) at neurology unit of a tertiary care teaching hospital of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Neurology department, Pak Emirates Military Hospital Rawalpindi, from Dec 2018 to Jun 2019. Methodology: This study was conducted on 69 patients of tuberculous meningitis admitted. Demographic profile included age, gender, and the symptoms with which the patient presented. Neurological complications were also documented among the target population. Outcomes included recovery, shifting to intensive care unit and death. Results: A total of 69 patients admitted in neurology ward diagnosed and managed as tuberculous meningitis in the study duration time. Male to female ratio was 1.4:1. Mean age of patients diagnosed with tuberculous meningitis in our study was 34.23 ± 3.915 years. Most of the patients presented with the fever follo...
Clinical profile and mortality predictors in hospitalised patients of tuberculous meningitis
Neurology Asia, 2023
Background& Objective: Tuberculous meningitis (TBM) is a serious public health problem in developing countries like India as it leads to significant mortality and neurological sequelae. Aim of study was to describe clinico-radiological profile of TBM and determine predictors of mortality. Methods: This was a prospective study and data collected including demographic details, clinical, laboratory parameters and neuroimaging finding. Diagnosis of TBM was based according to a standard case definition proposed by Marais et al.(2010). Results: One hundred and forty two TBM patients were recruited with 54.93% males and 45.07% females. Fever was most common symptom followed by headache, vomiting, altered sensorium and seizure. Most common cranial nerve palsy was of 6th cranial nerve followed by 2 nd cranial nerve. Cerebrospinal fluid (CSF)study in 77.46% of patients showed protein >100 mg/dL, 61.27% patients had CSF sugar <40 mg/dL while 87.32% of patients had total cell count >10 cells/cumm. Most common Neuroimaging finding was meningeal enhancement followed by hydrocephalus, infarcts, basal exudates and tuberculoma. In-hospital mortality was 17.61%. Higher age, low Glasgow Coma Scale (GCS) score, absence of headache, seizure, altered sensorium, anemia, low CSF glucose, infarct, hydrocephalus, and British medical research council (BMRC) Stage III at presentation were predictors of in-hospital mortality. Conclusions:. Age, GCS score, absence of headache, seizure, altered sensorium, anemia, low CSF glucose, infarct, hydrocephalus, and BMRC Stage III at presentation were predictors of in-hospital mortality based on this study from Bihar, India.
International Journal of Medical Research & Review, 2021
Introduction: Tuberculosis (TB) remains a worldwide burden with a large majority of new activecases occurring in underdeveloped and developing countries. This study is an attempt to look intovarious aspects of the disease that can be associated with the outcome, to promote a timely referralto an appropriate centre. Purpose: To identify various clinical, lab, CSF and radiological variablesassociated with poor outcome of TBM at the time of discharge. Material & Methods: Demographicdata, duration of symptoms before diagnosis, clinical presentation, staging of the disease at the timeof admission of all the TBM patients who presented to our centre between December, 2015 and May2018 were noted. Results of biochemical investigations and brain and spine imaging were retrieved.Outcome at the time of discharge as measured by MRC and mRS grades was correlated to clinicalprofile, lab, CSF and radiological findings. Results: A total of 100 patients were included. 15patients died. Subjects with M...
Features and Prognostic Factors of Tuberculous Meningitis in a Tertiary Hospital in Malaysia
Journal of Infectious Diseases and Epidemiology
Tuberculous meningitis (TBM) has been one of the major extrapulmonary manifestation with high morbidity and mortality. This paper aims to study the clinical features, prognostic factors and clinical outcome of TBM in a local tertiary hospital. This was an observational study on TBM in patients who were diagnosed in a local tertiary hospital. The patients' demographic data, medical history, clinical presentation at admission, radiological and microbiological data was reviewed along with the clinical course, treatment and outcome. Sixty one patients were recruited with 37 (60.7%) males and 24 (39.3%) females, with the mean age of 47.4 (SD 18.165). The main presenting features were fever (55.7%), headache (78.7%) and altered conscious level (78.7%). The most common imaging finding was hydrocephalus (43.3% in CT brain and 26.2% in MRI brain), followed by leptomeningeal enhancement (20% in CT brain and 42.9% in MRI brain) and infarct (21.7% in CT brain, 35.7% in MRI brain). The median total antitubercular therapy which patients received was 336 (IQR 332) days. There were 86.9% patients who survived the hospital admission, while 70.5% survived the 6 months follow-up period. Factors associated with poor prognosis were intubation on presentation, surgical intervention (either ventricular-peritoneal shunting or external ventricular drain), elevated CSF protein and presence of tuberculoma in cerebral imaging. This study highlights the importance of recognizing the clinical features and prognostic factors in TBM. A high index of clinical suspicion should always be maintained and supported by cerebrospinal fluid analysis and radiological features.
Journal of neurosciences in rural practice
Childhood tuberculosis is a major public health problem in developing countries with tubercular meningitis being a serious complication with high mortality and morbidity. To study the clinicopathological as well as radiological profile of childhood tuberculous meningitis (TBM) cases. Prospective, observational study including children <14 years of age with TBM admitted in a tertiary care hospital from Western India. TBM was diagnosed based on predefined criteria. Glassgow coma scale (GCS) and intracranial pressure (ICP) was recorded. Staging was done as per British Medical Council Staging System. Mantoux test, chest X-ray, cerebrospinal fluid (CSF) examination, neuroimaging, and other investigations were done to confirm TB. STATA software (version 9.0) was used for data analysis. Various risk factors were determined using Chi-square tests, and a P< 0.05 was considered significant. Forty-seven children were included, of which 11 (24.3%) died. Fever was the most common presentin...
Criteria indicating morbidity in tuberculous meningitis
JPMA. The Journal of the Pakistan Medical Association, 2012
To work out a criterion that may indicate morbidity in tuberculous meningitis. The retrospective study was conducted at the Medical Unit of the Liaquat University of Health Sciences, Jamshoro, Pakistan, and included cases related to a period between January 2006 and June 2011. Record of 50 patients were evaluated for clinical features, chest radiograph, Mantoux test, sputum for acid fast bacilli, routine investigations, cerebrospinal fluid studies, computerised tomography scan and magnetic resonance imaging of head. All the patients in the study had been treated with conventional approach. The severity of the condition was classified in stages, I, II and III. Clinical features, laboratory findings and imaging reports were analysed through SPSS 10 to find out the criteria indicating morbidity. Mean, median, standard deviation were calculated. Student t-test was applied on variables. Of the 50 patients, 26 (52%) were male and 24 (48%) were female. Their ages ranged from 12 to 70 years...
Pakistan Journal of Medical and Health Sciences, 2021
Aim: To determine the prevalence of hydrocephalus is in tuberculous bacterial meningitis patients Study Design: Cross sectional study Place and duration: This study was conducted in Pakistan Institute of Medical Sciences Islamabad, Pakistan From September 2019 to December 2020 Methodology: The technique of nonprobability, sequential sampling, was used. After a thorough examination, patients with tuberculous bacterial meningitis (TBM) were included. At the time of admission, a brief history of socio-demographics and the length of the illness was taken. The proforma was filled up with the results. The data were analyzed using SPSS Version 22. Results: Out of 120 patients, males made up 59.16 % cases. The age groups 20-30 years, 31-40 years, 41-50 years, and 51-60 years were represented in the study by 28 (23.33 %), 37 (30.83%), 17 (14.16 %), and 38 (31.66%) patients, respectively. The prevalence of hydrocephalus among TBM was 16.66%, with the 20-30 year age group having the most cases...