Tuberculous Meningitis: Report of 30 Cases

In this study, 30 cases of adult tuberculous meningitis treated in our department between August 1989-October 2002 were evaluated retrospectively according to history, physical examination, cerebrospinal fluid (CSF) analysis, laboratory and radio logically findings, clinical outcome, complication, efficacy of the treatment and sequel. Seventeen of them were male and 13 were female (mean age: 32.3 ± 17.2, range: 15-75). Four patients had either active or previous tuberculosis history. The most common complaints were vomiting (100%) and headache (93.3%), the most frequent finding was nuchal rigidity (100%). Only 9 (30%) patients had a positive CSF smear for acid-fast bacilli. Mycobacterium tuberculosis was isolated from 10 patient samples (33.3%). In 13 patients, CSF samples were evaluated with polimerase chain reaction (PCR) and 10 samples were found to be positive. The sequel rate was 16.7%. Mortality occured in 7 (23.3%) patients. It was established that the most important prognostic factor was clinical stage at the first admission