Assessment of Clinicopathological Status and Outcome of Children with Tuberculous Meningitis at a Tertiary Care Hospital

Abstract

Objective: The aim of this study is to report the clinic-pathological profile of children with TBM and their treatment outcome.
 Methodology: A retrospective observational study was conducted in the Pediatrics Department over 6 months period. Medical records of children admitted with TBM from November 2017 to May 2018 were reviewed for data collection. Data regarding clinical presentation, laboratory investigations were recorded. Patients were treated with a standard ATT regimen, and their outcome was noted. The study was approved by hospital ethics committee. Data was entered in SPSS for statistical analysis.
 Results: Females were predominant 39 (55.7%) and age ranged from 4 months to 13 years in this study. Only 28 (42.0%) children were fully vaccinated and had BCG scar presence. Most TBM cases were of stage II 24 (42.8%) or stage III 29 (42.8%). The frequent symptoms were fever 61 (87.1%), rigidity/irritability 35 (50.0%), and seizures 26 (37.1%). WBCs count in CSF was found below 500 in 64 (91.4%) children. There were 55 (78.5%) children with lymphocytosis and 14 (20.0%) with polymorph nuclear cells. A CT scan was suggestive of TBM in 51 (72.8%) children. Only 21 (30.0%) cases had a complete recovery whereas 17 (24.2%) recovered with sequelae and 10 (14.2%) deaths were noted.
 Conclusion: TBM presents with a poor clinical and pathological state in the advanced stage of the disease, and the therapy outcome is also non-satisfactory with high mortality and sequelae posing constant challenges.