Clinical case series of nine patients with tuberculousmeningitis in the Clinical Centre of Vojvodina, Novi Sad, AP Vojvodina, Serbia 2001-2010

Abstract

Aim: To determine immediate risk factors of developing tuberculous meningitis, to assess the practical importance of clinical signs and findings in the cerebrospinal fluid (CSF) when opting for the specific therapy, and to predict the outcome of disease in relation to the beginning of treatment. Methods: A retrospective clinical case series of nine patients with tuberculous meningitis who were treated from April 2001 until November 2010 at the Department of Infectious Diseases in Novi Sad, Serbia was presented. Data of patients' medical records and presentation of clinical and laboratory features, neuro radiological findings and outcome were used. Results: The factors of immediate risk/predisposition for the development of tuberculous meningitis were found in two (22.2%) patients. The duration of symptoms prior to admission was 9 days on average (from 3 to 20 days). The most frequent symptoms on admission were headache and fever in eight (88.9%) patients, whereas two patients (22.2%) were presented with stiff neck and photophobia. Consciousness was preserved in six patients (66.7%), two patients were somnolent and one was in coma. Two(22.2%) patients had concurrent pulmonary tuberculosis. Neuroradiological signs of the disease were present in two patients. Conclusion: The duration of symptoms before admission, clinical examination and CSF analysis can be helpful in identifying patients who are at high risk of developing tuberculous meningitis.