ArticleAIDS research and therapy2013
Tuberculous meningitis: presentation, diagnosis and outcome in hiv-infected patients at the douala general hospital, cameroon: a cross sectional study.
Article in AIDS research and therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Bacterial meningitis in Africa.Frontiers in neurology · 2023Review
- Treatment outcomes and risk factors of death in childhood tuberculous meningitis in Kandahar, Afghanistan: a prospective observational cohort study.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2022Observational
- Treatment Outcomes in Adult Tuberculous Meningitis: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2020Article
- Neurological complications after tuberculous meningitis in a multi-state cohort in the United States.Journal of the neurological sciences · 2017Article
- HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment.Nature reviews. Neurology · 2016Review
- Etiologies and Management of Aseptic Meningitis in Patients Admitted to an Internal Medicine Department.Medicine · 2016Observational
- Clinical Presentation, Aetiology, and Outcomes of Meningitis in a Setting of High HIV and TB Prevalence.Journal of tropical medicine · 2015Article
- Central Nervous System Tuberculosis: Challenges and Advances in Diagnosis and Treatment.Current infectious disease reports · 2013Article
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Abstract
introductionTuberculous meningitis (TBM) the most fatal presentation of tuberculosis (TB) especially in HIV-infected patients is a real diagnostic and therapeutic challenge worldwide. In Cameroon where HIV and TB are amongst the leading public health problems, the magnitude of TBM has not been defined. Therefore, the objective of this cross sectional study was to describe the presentation and in-hospital outcome of TBM among HIV patients in Douala as well as its diagnostic difficulties.
methodsWe did a clinical case note analysis of all HIV-1 infected patients treated for TBM in the Internal medicine unit of the Douala General Hospital, between January 1st 2004 and December 31st 2009. The diagnosis of TBM was made using clinical, laboratory [cerebrospinal fluid (CSF) analysis] and/or brain computerised tomographic (CT) scan features.
resultsDuring the study period, 8% (54/672) of HIV-infected patients had TBM. Their mean age was 40.3 ± 12.7 years. The main presenting complaint was headache in 74.1% (40/54) of patients. Their median CD4 cell count was 16 cells/mm3 (IQR: 10 - 34). CSF analysis showed median protein levels of 1.7 g/l (IQR: 1.3 - 2.2), median glucose level of 0.4 g/l (IQR: 0.3 - 0.5) and median white cell count (WCC) count of 21 cells/ml (IQR: 12 - 45) of which mononuclear cells were predominant in 74% of CSF. Acid fast bacilli were found in 1.9% (1/54) of CSF samples. On CT scan hydrocephalus was the main finding in 70.6% (24/34) of patients. In hospital case fatality was 79.6% (43/54).
conclusionTBM is a common complication in HIV-infected patients in Douala with high case fatality. Its presumptive diagnosis reposes mostly on CSF analysis, so clinicians caring for HIV patients should not hesitate to do lumbar taps in the presence of symptoms of central nervous system disease.
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