International Journal of Research in Medical Sciences | June 2023 | Vol 11 | Issue 6 Page 1914
International Journal of Research in Medical Sciences
Ahmed K et al. Int J Res Med Sci. 2023 Jun;11(6):1914-1918
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Clinical presentations among adult patients with tuberculous meningitis
Kamal Ahmed
1
*, Md Mubin Uddin Akhanji
2
, Md Shahidul Islam
3
, K. M. Ahasan Ahmed
4
,
Md Zakirul Islam
5
INTRODUCTION
Tuberculosis (TB) is a global pandemic and is caused by
the Mycobacterium tuberculosis complex.
1
It causes ill
health for approximately 10 million people each year and
is one of the top ten causes of death worldwide and the
second leading cause of death from an infectious disease
after HIV.
2,3
According to recent data, the disease causes
approximately 9 million new cases and 1.5 million deaths
each year.
1
TBM (tuberculous meningitis) is a
particularly important public health issue in our country.
Bangladesh is a country with a high burden of pulmonary
as well as extrapulmonary tuberculosis. TB can affect
various organs of the body, but it most commonly affects
the lungs and is known as pulmonary TB. When TB
affects other organs, it is recognized as extra-pulmonary
TB. The majority of the pulmonary cases are pulmonary
TB, while only 15-20% of cases are extrapulmonary
1
Department of Neurology, North East Medical College and Hospital, Sylhet, Bangladesh
2
Department of Psychiatry, M. A. G. Osmani Medical College, Sylhet, Bangladesh
3
Department of Medicine, Government Employee Hospital, Fulbaria, Dhaka, Bangladesh
4
Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
5
Department of Medicine, Kurmitola General Hospital, Dhaka, Bangladesh
Received: 12 March 2023
Accepted: 09 May 2023
*Correspondence:
Dr. Kamal Ahmed,
E-mail: docdrkamal@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Bangladesh is a country with a high burden of pulmonary as well as extrapulmonary tuberculosis. TBM
is a particularly important public health issue in our country. Identifying prognostic predictors would improve the
quality of management and ultimately will prevent long-term mortality and morbidity. The aim of the study was to
observe and identify the most common clinical presentations among patients with tuberculous meningitis.
Methods: This hospital-based prospective cohort study was carried out at the in-patient Department of Clinical
Neurology at the National Institute of Neurosciences and Hospital (NINS and H), Dhaka, Bangladesh from October
2016 to September 2017, 1 year. A total of 54 patients admitted to the hospital with features of tuberculous meningitis
(TBM) were selected for the study following inclusion and exclusion criteria.
Results: Over 70% of patients were adolescents or young adults with a mean age of 28.2±12.3 years. The majority
(48.2%) of the participants were from TBM stage II, while 37% were from stage III of TBM. Fever, headache, and
systematic symptoms were the most frequent clinical presentations. The median delay in treatment was 30 days.
Interruption in anti-TB treatment was reported in 3 (9.3%) cases.
Conclusions: The study found that among possible TBM cases, the most frequent clinical features were fever,
headache, and systematic symptoms. Focal neurological deficit and cerebral nerve palsy also had a high prevalence
among the participants. The majority of the participants were young adults and female prevalence was high in the
present study. The majority were from stage II TB among the study participants.
Keywords: Clinical presentations, Meningitis, Respiratory, Tuberculosis
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20231601