Shahzadi Asma Tahseen.
Tuberculous Meningitis at Tertiary Care Unit.
Pak Paed J Jan ;40(1):28-33.

Introduction: Tuberculous meningitis is not an uncommon cause of prolonged morbidity and mortality in our set up. Objective of the Study: To describe our experiences in the presentation, diagnostic rigor and outcome of the disease in our setup. Methods and Material: The record of 100 cases of tuberculous meningitis admitting from 1st February 2013 to 31st March 2014 in Pediatric unit I, Bahawal Victoria Hospital Bahawalpur was reviewed. Result: There were 100 cases, out of which 59% were male. The mean ± SD age of presentation was 36.91 ± 32.23 months. There were only children 20% who were above 5 years of age. The contact was positive in 24% cases. 31% were having BCG scar mark. 94% cases were admitted in stage III while only 6% in stage II. The mean ± SD duration of preadmission symptoms was 14.77 ± 6.74 days. The initial chest radiograph was abnormal in 40% cases. Cranial CT showed hydrocephalus in 93% and multiple infarctions in 45% cases, tuberculoma in 2% and basilar enhancement in 95% cases. The mean ± SD CSF white blood cell count (mm3) at time of presentation was 246.8 ± 174.2. Predominant cells were lymphocytes in 93% while polymorph nuclear leukocytes in 7% of the cases. The mean ± SD CSF protein (mg/dl) at time of presentation was 153.53 ± 65.39 and that of glucose (mg/dl) 31.47 ± 13.11. The case fatality during hospital stay was 25%. Conclusion: Tuberculous meningitis is an important childhood illness with high mortality and morbidity having non specific signs and symptoms.

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