Clinical profile of tuberculous meningoencephalitis in pediatric patients at a tertiary care center
DOI:
https://doi.org/10.18203/2349-3291.ijcp20261526Keywords:
Tuberculous meningoencephalitis, Childhood tuberculosis, BCG vaccination, Malnutrition, HydrocephalusAbstract
Background: Tuberculous meningoencephalitis (TBME) is the most severe form of childhood tuberculosis and is associated with high mortality and long-term neurological sequelae. Despite availability of effective anti-tubercular therapy, delayed diagnosis, malnutrition, and poor immunization status continue to adversely affect outcomes in children.
Methods: This prospective observational study was conducted from January 2023 to June 2024 in the paediatric wards and pediatric intensive care unit of a tertiary care centre in western India. Children aged 1 month to 12 years diagnosed with TBME were included. Detailed clinical evaluation, laboratory investigations, neuro imaging, Bacillus Calmette–Guérin (BCG) vaccination status, nutritional status, complications, and outcomes were recorded using a pre-structured proforma.
Results: A total of 75 children with TBME were studied. Majority of patients (68%) were below five years of age. Fever, seizures, vomiting, and altered sensorium were the most common presenting features. BCG-vaccinated children had milder disease and better outcomes. Malnutrition was significantly associated with advanced disease stage, increased complications, and poor neurological outcome. Hydrocephalus was the most common complication. Mortality was higher in children with severe malnutrition and advanced stage of disease.
Conclusion: TBME remains a serious and life-threatening illness in children. BCG vaccination and good nutritional status play a protective role. Early diagnosis, prompt initiation of antitubercular therapy, and aggressive management of complications are essential to reduce morbidity and mortality.
References
World Health Organization. Global tuberculosis report 2023. 2023. Available at: https://www.who.int /teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2023. Accessed on 12 February 2026.
Rock RB, Olin M, Baker CA, Molitor TW, Peterson PK. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev. 2008;21(2):243-61.
Thwaites GE, Hien TT. Tuberculous meningitis: many questions, too few answers. Lancet Neurol. 2005;4(3):160-70.
Kennedy DH, Fallon RJ. Tuberculous meningitis. JAMA. 1979;241(3):264-8.
Hosoglu S, Ayaz C, Geyik MF, Kokoglu OF, Ceviz A. Tuberculous meningitis in adults: an eleven-year review. Int J Tuberc Lung Dis. 1998;2(7):553-7.
van Well GTJ, Paes BF, Terwee CB, Springer P, Roord JJ, Donald PR, et al. Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western world. Pediatrics. 2009;123(4):e634-43.
Trunz BB, Fine P, Dye C. Effect of BCG vaccination on childhood tuberculous meningitis and miliary tuberculosis worldwide: a meta-analysis and assessment of cost-effectiveness. Lancet. 2006;367(9517):1173-80.
Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. Int J Tuberc Lung Dis. 2004;8(3):286-98.
Garg RK. Tuberculous meningitis. Acta Neurol Scand. 2010;122(2):75-90.
Abdella R, Tesfaye T, Yalew A. Tuberculous meningitis in children: clinical profile, treatment outcomes and predictors of mortality. Ethiop J Health Sci. 2019;29(1):23-30.
Israni AV, Dave DA, Mandal A. Clinical profile and outcome of tuberculous meningitis in children at a tertiary care hospital. Indian J Pediatr. 2018;85(7):563-8.
Seth V, Kabra SK, Jain Y. Tuberculous meningitis: clinical profile and outcome in children. Indian Pediatr. 1998;35(5):431-7.
Vyas S, Kumar R, Garg A. Neuroimaging findings in pediatric tuberculous meningitis and their correlation with clinical outcome. J Trop Pediatr. 2016;62(4):285-92.
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