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Early Mortality among Immunocompetent Patients of Tuberculous Meningitis: A Prospective Study
Most deaths in tuberculous meningitis occur in the early part of the illness. We assessed the determinants of early deaths, occurring within 2 months of intensive therapy. We prospectively included consecutive newly diagnosed adults with HIV-negative tuberculous meningitis. Patients were given WHO-recommended antituberculosis treatment and were followed up for 9 months. We enrolled 152 patients. A total of 26 deaths were recorded during 2 months. The logistic regression analysis revealed that papilledema (P = 0.029, odds ratio (OR) = 4.8 [1.2–19.8]), increasing age (P = 0.001, OR = 1.07 [1.03–1.1]), stage-III disease (Glasgow coma scale score ≤ 10; P = 0.01, OR = 4.2 [1.4–12.3]), and hydrocephalus (P = 0.003, OR = 8.4 [2.1–33.6]) were independently associated with death. In addition, cerebral infarcts (P = 0.012, OR = 5.6 [1.5–21.3]), paraparesis (P = 0.004, OR = 8.8 [2.02–38.1]), and age (P = 0.005, OR = 1.05 [1.02–1.09]) were associated with poor functional outcome. In conclusion, disease severity predicts early deaths in tuberculous meningitis.
Author Notes
Authors’ addresses: Ravi Shekhar Jaipuriar, Ravindra Kumar Garg, Imran Rizvi, Hardeep Singh Malhotra, Neeraj Kumar, Rajesh Verma, Praveen Kumar Sharma, Shweta Pandey, and Ravi Uniyal, Department of Neurology, King George Medical University, Lucknow, India, E-mails: jaipuriarshekhar@gmail.com, garg50@yahoo.com, imranrizvi09@gmail.com, drhsmalhotra@yahoo.com, drneeraj2903@gmail.com, drrajeshverma32@yahoo.com, pspgimer@gmail.com, dr.shweta.md@gmail.com, and ravi.sun.uniyal@gmail.com. Amita Jain, Department of Microbiology, King George Medical University, Lucknow, India, E-mail: amita602002@yahoo.com.
These authors contributed equally to this work.