CLINICORADIOLOGICAL PRESENTATION OF TUBERCULOUS MENINGITIS IN PAEDIATRIC PATIENTS
Keywords:
Tuberculous, Meningitis, Paediatric, Clinical, Laboratory, Cerebrospinal fluidAbstract
Objectives: To know the clinicoradiological presentation of paediatric patients suffering from Tuberculous Meningitis
(TBM).
Material and Methods: This was a descriptive study done on 40 patients, which was carried out in the Department of
Paediatrics Khyber Teaching Hospital, Peshawar from January 2007 to December 2008. In this study suspected
cases of TBM were evaluated on clinical, laboratory and radiological basis.
Results: Forty patients with TBM with age range from 8 months to 12 years were included in this study. There were 24
(60%) male and 16(40%) female patients. The mean duration of illness was 30 days (range 1 to 90 days). Fever was
present in 36 (90%) patients, weight loss in 28 (70%) patients, Signs of raised intrcranial pressure in 26 (65%)
patients, vomiting in 20 (50%) patients, altered consciousness in 20 (50%) patients, and headache in 16 (40%)
patients. Cerebrospinal fluid findings like raised protein, low glucose and lymphocyte pleocytosis were observed in
30 (75%) patients. CSF culture was positive only in 4 (10%) patients and CSF for AFB by Ziehl-Neelsen method was
present in 5 (12.5%) patients. Eighty percent of patients with TBM presented with stage 2 and 3 disease. Twenty
(50%) patients died during hospital stay. Fifteen patients recovered with neurological deficit. Only 5 patients had
complete recovery. The most frequent neurological sequlae observed was 6th nerve palsy (30%).
Conclusion: Presentation of TBM patients is variable. Therefore a high index of suspicion is needed. Patients must
be subjected to lumbar puncture for early initiation of anti-tuberculous therapy. Immunization status of the children
should be improved and education about proper follow up should be given.
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