Hammad U. Qureshi, Shehzad N. Merwat, Saman A. Nawaz, Azhar A.K. Rana, Amara Malik, Mahvesh K. Mahmud, Asad Latif, Amanullah Khan, Arif R. Sarwari.
Predictors of Mortality in 190 Adult Patients with Tuberculous Meningitis..
Infect Dis J Jan ;9(2):15-8.

Tuberculous meningitis (TBM) carries significant morbidity and mortality. To date, scant literature is available regarding TBM in Pakistan. All adult patients with TBM admitted to the Aga Khan Universiy Hospital, a tertiary care teaching hospital in Karachi, Pakistan, were reviewed retrospectively. Our aim was to describe the demographic profile, clinical features, laboratory and radiological pictures of these patients and to identify predictors of mortality. Among the 190 patients analyzed, the largest age category was the 21-30 age group (28%). Fever (90%), impaired consciousness (63%) and nausea/vomiting (50%) were the most common presenting symptoms. Thirty four percent were categorized as clinical stage III. CSF cultures were positive in only 5%. Thirty seven percent had an associated lung pathology on a chest X-ray. Neuroimaging revealed meningeal enhancement in 27% and hydrocephalus in 23%. All patients were started on antituberculous therapy and 79% received a concomitant steroid therapy. Neurosurgical intervention was required in 13% and mechanical ventilatory support in 12%. Overall mortality was 20% and neurological sequelae were identified in 42% of the survivors. Univariate analysis showed age greater than sixty years, clinical stage III and mechanical ventilation as predictors of mortality. The logistic regression model, however, revealed that stage III presentation was not an independent predictor.

USER COMMENTS

The abstract rveals interesting results.Wrer tuberculomas present or not, and in what percntage?
Posted by: rpmesa on Jun 2001

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com