DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20164589

Clinical and laboratory profile of children with tubercular meningitis admitted in tertiary care centre of Kumaun region, Uttarakhand, India

Garima Goyal, Ajay Kumar Arya

Abstract


Background: Tuberculous meningitis (TBM) is an important cause of hospital admission, death and neurological disability in India. Delay in diagnosis is an important cause of morbidity and mortality.

Methods: 80 cases with meningitis 1 month-16 year were enrolled, 44 diagnosed as TBM, studied in detail about clinical and laboratory profile. The data was analyzed by statistical test SPSS 21 and Chi square test was applied.

Results: Peak age incidence 11-16 year. Youngest patient 3 month. Male: female ratio 0.8:1. Majority of patients had fever, altered sensorium, vomiting, headache, seizures. Neurological deficit found was loss of speech, right sided weakness, and diplopia. 36.3% patients were comatose. Cranial nerve palsy was present in 57% cases, 6th nerve being the commonest. Papilloedema common than optic atrophy. Motor deficit like hemiplegia (4.5%). Maximum cases were in stage III BMRC. CSF findings were reduced glucose level in 47.7% of cases (mean 54.5 mg/dl), elevated protein (mean 116.9 mg/dl), lymphocytic pleocytosis (mean value 102.46) (>60% lymphocytes). CT scan abnormality in 75% cases. Hydrocephalus being the most common finding.

Conclusions: TBM one of most serious illness. Majority patients presented in stage 3 with neurological deficit, as this are tertiary care centre and due to difficult geographic terrain patient presents at late stage. High index of suspicion to diagnose TBM at early stage. CSF analysis continues to be a key in establishing the diagnosis. One should not wait for the microbiological proof to start the therapy. Mantoux and radiological tests can be good supportive investigation. Early diagnosis and treatment can make complete recovery even in comatose patients. 


Keywords


Cerebrospinal fluid, Laboratory profile, Neurological deficit, Tuberculous meningitis

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