Tuberculous Meningitis in Adults in Turkey: Epidemiology, Diagnosis, Clinic and Laboratory

A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were re...

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Bibliographic Details
Published in:European journal of epidemiology 2003-01, Vol.18 (4), p.337-343
Main Authors: Hoşoǧlu, S., Geyik, M. F., Balik, İ., Aygen, B., Erol, S., Aygencel, Ş. G., Mert, A., Saltoǧlu, N., Dökmetaş, İ., Felek, S., Sümbül, M., Sünbül, M., Irmak, H., Aydin, K., Ayaz, C., Kökoǧlu, Ö. F., Uçmak, H., Satilmiş, S.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Cerebrospinal fluid
Computerized axial tomography
Epidemiology
Female
Hospitals, University - statistics & numerical data
Humans
Infectious diseases
Male
Meningeal tuberculosis
Microbiology
Middle Aged
Mycobacterium tuberculosis
Retrospective Studies
Symptoms
Time Factors
Tuberculosis
Tuberculosis, Meningeal - cerebrospinal fluid
Tuberculosis, Meningeal - diagnosis
Tuberculosis, Meningeal - epidemiology
Turkey - epidemiology
University hospitals
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Summary:A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity.
ISSN:0393-2990
1573-7284