Last modified: 2018-09-09
Abstract
Tubercular meningitis (TBM) is the most life threatening manifestation of tuberluosis with high degree of mortality and morbidity.
Aims and objectives:To study the Clinical profile, Radiological findings, yield of GeneXpert and outcome of TBM among children.
Material and MethodsTotal 36 children with tubercular meningitis were included in the study from January 2015 to June 2018. Clinical , laboratory profile and treatment outcomes recorded. Stastics with SPSS 20th version.
RESULTS
Mean age was 36 months. 14 (38%) had definitive TBM, 20 (56%) probable TBM and 2 (6%) possible TBM. Majority had fever, altered sensorium, headache, seizures. Hemiplegia in 76%, Cranial nerve palsy in 53%. CSF –GeneXpert was positive in 38%. Hydrocephalus and basal exudates (75%) being the most common radiological finding. Surgical intervention performed in 14/26 children with hydrocephalus. Ommayya reservoir was placed in 7/14 children out of which 7 children needed VP shunt and in 5/14 direct VP shunt was placed. Three patients died. 78% had good outcome and 22% had poor outcome at discharge according to Modified Glasgow outcome scale. One each had spinal arachnoiditis, Bickerstaff encephalitis and PAID syndrome. Stage III disease, low GCS at presentation and cerebral infarcts were associated with poor outcome. Learning difficulties with poor scholastic performance was evident in 4/17 (23.5%) of school going children at follow up.
CONCLUSION
CSF GeneXpert yield was only 38% of our cases. 50% with hydrocephalus were managed conservatively.