Clinical, Laboratory, and Radiological Evaluation of 32 Cases with Tuberculous Meningitis

Abstract

Introduction: Tuberculous meningitis is an important central nervous system infection, and it is the most severe clinical form of tuberculosis. Mycobacterium tuberculosis is the frequently isolated microorganism, and it is associated with high morbidity and mortality among central nervous system infections. Despite all the advances in medicine, diagnosis of tuberculous meningitis is still a significant problem. In our study, we aimed to evaluate clinical, microbiological and radiological features of the patients with tuberculous meningitis in detail. Materials and Methods: The study was designed as a retrospective study. A total of 32 patients diagnosed on the basis of clinical, microbiological and radiological criteria with tuberculous meningitis were included into the study. Patients were exposed to computed tomography scan and magnetic resonance imaging with the exception of two patients. Computed tomography scans were performed at the time of admission to the emergency department while magnetic resonance imagings were performed within the 48 hours after computed tomography scans. The data were analyzed with SPSS 24. Results: Eleven of the patients were diagnosed with gold standard methods. The pathogen microorganism was M. tuberculosis in all cases. The diagnoses of other patients were determined by clinical; microbiologic and radiologic estimations. Demographic findings-symptoms of the patients, laboratory findings-symptoms and the contribution of radiology to the diagnosis were evaluated. Particularly, when the contribution of radiology to the diagnosis was studied, it was found that especially magnetic resonance imaging was more useful than computed tomography. Conclusion: Central nervous system infections due to M. tuberculosis are frequently related to high morbidity and mortality. The gold diagnosis methods of the disease are; isolation of M. tuberculosis from the cerebrospinal fluid or seeing the microorganism in the fluid with EZN stain. Because of the low positivity rates in gold standard methods, radiologic methods such as magnetic resonance imaging can be used in tuberculous meningitis diagnosis.