Retrospective evaluation of the patients with tuberculous meningitis for early diagnosis

Tuberculous meningitis is associated with high morbidity and mortality if there is a delay in diagnosis. 32 children clinically suspected to have tuberculous meningitis were included in this study. History, examination, CSF findings and CT scan were recorded 21 patients were younger than five years, a contact source was identified in 13 patients (%40). Previous BCG had only been given to 9 (%28). The Mantoux reaction was positive in 9 (%28), abnormalities of the chest X- ray were found 6 (%18). %57 percent of these patients presented with stage II and 31 percent of the patients presented with stage III. Mycobacterium tuberculosis was either culture or identified by acid-fast stain from CSF and early morning gastric aspirates in six patients. Cranial tomography scans of the patients showed hydrocephalus in fourteen patients (%43) and basillar enhancement in four patients, Tuberculoma in five patients. The diagnoisis of CNS tuberculosis should be considered in all children with neurologic signs and symptoms of, and risk factors for tuberculosis.

Tüberküloz menenjitli hastalarýn erken taný için retrospektif taranmasý

Tüberküloz menenjit erken taný konulamadýðýnda, yüksek oranda mortalité ve morbiditeye sebep olmaktadýr. Bu amaçla klinik olarak tüberküloz menenjit olduðu düþünülen 32 hasta retrospektif olarak incelendi. Hikaye, fizik muayene, BOS ve kraniyal tomografi bulgularý kaydedildi. 21 hasta beþ yaþ altýndaydý, tüberkülozlu olduðu bilinen bir vakayla temas öyküsü 13 (%40) hastada, Mantoux deri testi pozitifliði 9 hastada (%2B) saptandý. BCG aþýsý 9 (%28) hastaya yapýlmýþtý. 6 hastada (%J8) göðüs radyogramýnda anormallik saptandý. Hastalarýn %57’si ilk baþvuruda Evre ÝT de, %31’i Evre III’ deydi. 3 hastada BOS ya da açlýk mide suyunda Mycobacterium tuberculosis kültürde üretildi, 3 hastada asiclo rezistan boyamayla basil saptandý. Kraniyal tomografide 14 hastada (%43) hidrosefali, 4’ünde (%12) bazitler tutulum, 5’inde (%15) tüberküloma tespit edildi. Nörolojik semptom ve bulgularý olan ve tüberküloz için risk faktörü taþýyan tüm çocuklarda ilk akla gelen MSS tüberkülozu olmalýdýr.