Clinical and Diagnostic Findings Among Tubercular Meningitis Patients without Pulmonary Signs and Symptoms

Abstract

Background: Tubercular meningitis (TBM) is the most frequent one among the different forms of CNS tuberculosis. Early diagnosis, as well as treatment of tubercular meningitis (TBM), can give an excellent outcome with minimal residual morbidity. Clinical and diagnostic findings of patients without pulmonary signs and symptoms may be useful for the treatment of suspected tubercular meningitis patients. Aim of the study: This study aimed to make a patient profile on the clinical and diagnostic findings of tubercular meningitis patients without pulmonary signs and symptoms. Methods: This cross-sectional study was conducted in the Department of Medicine, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh, from September 2020 to August 2021. A total of 77 confirmed cases of tubercular meningitis without pulmonary signs and symptoms admitted to the mentioned hospital were enrolled in this study as the study population. A purposive sampling technic was used in sample selection. Along with the clinical and diagnostic findings, all relevant information was recorded in a data collection sheet. Results: In this study, 61% of the study population had a family history of TB. Among all the patients, all had fever, 80.5% had headache, 68.8% had altered sensation, 62.3% had anorexia and nausea, 55.8% had vomiting, 19.5% had a convulsion and 15.6% had neck stiffness. In our settings, the majority (46.8%) of the respondents had TBM Grade II. The mean WBC count was 134.80±34.59 106/L, Lymphocyte (%) was 79.49±11.77, Glucose was 26.49±5.43 mg/dl, Protein was 142.8±72.5 and ADA level was 12.08±1.29 U/L. In our settings, 58.4% of the respondents had Mantoux test and 36.4% showed chest X-ray positive. In this study, 22.1% of the respondents had CT scan or MRI findings normal. Conclusion: A family history of tuberculosis may be a potential factor for TBM. Fever, headache, altered sensation, anorexia/nausea and vomiting are very common clinical features in such patients. Chest X-ray ..