Tuberculous meningitis: symptoms, diagnosis and evaluation experienced in 532 patients in a pediatric hospital

Abstract Objective To analyze the procedures to manage tuberculous meningitis (TM) employed in a third level hospital. Methods A descriptive study was carried out on the procedures used to manage TM in 532 children attended at the Infectology Service of National Institute of Pediatrics of Mexico City. Patients included must have analysis of cerebrospinal fluid suggestive of TM and negative for other bacteria among others criteria. Results The predominant signs observed were fever in 486 patients, apathy in 485, somnolence in 477, headache in 173, seizure crisis in 400 and coma progression in 17. Cerebrospinal fluid showed an average of 199 cells/mL, proteins 170.8 mg. Chest X-ray showed abnormalities in 330 cases and brain tomography revealed basal arachnoiditis in 306 cases. 24 patients died and 414 of them had audition and epileptic sequels. Conclusions TM has continued to be a serious health problem in developing countries. Delay in diagnosis of this disease is a cause of the increase not only of its morbidity but also its mortality as well as its sequels.