Research Articles

Tuberculosis meningitis, Abbassia Fever Hospital-Naval Medical Research Unit No. 3-Cairo, Egypt, from 1976 to 1996

A total of 1,430 patients with the presumptive diagnosis of tuberculous meningitis were admitted to the U.S. Naval Medical Research Unit No. 3/Abbassia Fever Hospital in Cairo, Egypt from January 1976 to January 1996. Diagnosis was confirmed by culture of the mycobacteria from the cerebrospinal fluid CSF of 857 patients and these patients are included in the final analysis. There were 497 males and 360 females. The patients ranged in age from five months to 55 years. The number of patients admitted during the months of March, April, and May were more than double those admitted during October, November, and December. The duration of symptoms prior to admission ranged from seven to 90 days (mean = 29.5 days). Upon admission, 4% of the patients were alert, 34% were drowsy, and 62% were in a coma. Of the 857 patients studied, 490 (57%) died, 256 (30%) recovered completely, and 11 (13%) recovered with sequelae. The mortality and neurologic sequelae were directly related to the stage of disease and duration of symptoms prior to admission. Mortality was significantly lower in patients admitted in stage II and or with short duration of disease compared with those in stage III and or with prolonged duration of symptoms prior to admission. The use of dexamethasone in patients with tuberculous meningitis significantly reduced the ocular complications that occur in these patients and also significantly reduced the fatality rate.

This article has been cited by other articles:

				G. T. J. van Well, B. F. Paes, C. B. Terwee, P. Springer, J. J. Roord, P. R. Donald, A. M. van Furth, and J. F. Schoeman Twenty years of pediatric tuberculous meningitis: a retrospective cohort study in the western cape of South Africa. Pediatrics, January 1, 2009; 123(1): e1 - e8. [Abstract] [Full Text] [PDF]

				R. B. Rock, M. Olin, C. A. Baker, T. W. Molitor, and P. K. Peterson Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects Clin. Microbiol. Rev., April 1, 2008; 21(2): 243 - 261. [Abstract] [Full Text] [PDF]

				M. E. Torok, H. D. T. Nghia, T. T. H. Chau, N. T. H. Mai, G. E. Thwaites, K. Stepniewska, and J. J. Farrar Validation of a Diagnostic Algorithm for Adult Tuberculous Meningitis Am J Trop Med Hyg, September 1, 2007; 77(3): 555 - 559. [Abstract] [Full Text] [PDF]

				N. P. Shah, A. Singhal, A. Jain, P. Kumar, S. S. Uppal, M. V. P. Srivatsava, and H. K. Prasad Occurrence of Overlooked Zoonotic Tuberculosis: Detection of Mycobacterium bovis in Human Cerebrospinal Fluid J. Clin. Microbiol., April 1, 2006; 44(4): 1352 - 1358. [Abstract] [Full Text] [PDF]

				A. Pandit, A. Arjyal, J. Farrar, and B. Basnyat Nepal Practical Neurology, April 1, 2006; 6(2): 129 - 133. [Full Text] [PDF]

				G. E. Thwaites, N. D. Bang, N. H. Dung, H. T. Quy, D. T. T. Oanh, N. T. C. Thoa, N. Q. Hien, N. T. Thuc, N. N. Hai, N. T. N. Lan, et al. Dexamethasone for the Treatment of Tuberculous Meningitis in Adolescents and Adults N. Engl. J. Med., October 21, 2004; 351(17): 1741 - 1751. [Abstract] [Full Text] [PDF]

				D. A. Drevets, P. J. M. Leenen, and R. A. Greenfield Invasion of the Central Nervous System by Intracellular Bacteria Clin. Microbiol. Rev., April 1, 2004; 17(2): 323 - 347. [Abstract] [Full Text] [PDF]

				R. C. Cooksey, S. H. Abbadi, C. L. Woodley, D. Sikes, M. Wasfy, J. T. Crawford, and F. Mahoney Characterization of Mycobacterium tuberculosis Complex Isolates from the Cerebrospinal Fluid of Meningitis Patients at Six Fever Hospitals in Egypt J. Clin. Microbiol., May 1, 2002; 40(5): 1651 - 1655. [Abstract] [Full Text] [PDF]