Factors associated with poor outcome in tuberculous meningitis; study from a tertiary care referral Center

Abstract

Background:Tuberculosis (TB) caused by Mycobacterium tuberculosis is a leading cause of death globally. While TB commonly
affects the lungs, it can also manifest in other parts of the body, leading to extra-pulmonary TB (EPTB).The objective of this study
is to explore the factors that contribute to a negative outcome in children affected by tuberculous meningitis (TBM).
Materials & methods:A total of 50 children were enrolled. Complete demographic and clinical details of all the patients was
obtained. Only those patients were enrolled which were confirmed cases of TBM. A questionnaire was obtained and following
details were recorded:Duration of symptoms,Duration of hospital stay, Signs and symptoms, and Clinical staging of the disease.
Radiographic findings of all the patients were recorded. Poor clinical outcome is defined as death. All the results were recorded in
Microsoft excel sheet and was subjected to statistical analysis using SPSS software.
Results: Mean age of the patients was 16.2 years. Headache, fever, vomiting and anorexia was seen in 70 percent, 66 percent, 40
percent and 10 percent of the patients respectively. Cranial nerve palsy and altered sensorium was seen in 30 percent and 46 percent
of the patients respectively. While conducting univariate analysis, it was seen that altered sensorium, elevated CSF pressure, MRC
staging III on admission and presence of vasculitic infarcts were considered as significant risk factors associated with poor
prognosis.
Conclusion:The Modified Rankin Scale (MRC) at admission is one of the independent variables that significantly influence the
outcome upon discharge in cases of paediatric TBM.
Key words: Tuberculous meningitis, Poor outcome