Figure 1.
Flow diagram of differential diagnoses in patients with ‘markedly abnormal’ CSF and/or microbiological-confirmed meningitis.
1 Common alternative diagnoses include: hypoglycemia (n = 9), intracranial bleed (n = 7) and peripheral nerve disorders (n = 6). 2 Including 5 patients with CSF culture-confirmed bacterial meningitis. Organisms isolated include: Streptococcus pneumonia (n = 3), beta-hemolytic Streptococcus (n = 1), Neisseria meningitides (n = 1). 3 Including 1 patient with positive CSF polymerase chain reaction for both cytomegalovirus and herpes simplex-1 virus. 4 Other causes of meningitis include: Acute HIV infection (n = 1), Toxoplasma gondii meningoencephalitis (n = 1), disseminated Burkitt's lymphoma (n = 1), disseminated large B-cell lymphoma (n = 1), chronic resolving TBM immune reconstitution inflammatory syndrome (n = 1). 5 Including patients with the following differential diagnoses: 1) TBM with tuberculoma or toxoplasmosis (n = 1); 2) partially treated bacterial meningitis, viral meningitis or TBM (n = 3); and 3) viral meningitis or TBM (n = 3). CSF, cerebrospinal fluid.
Table 1.
Demographic and clinical characteristics of patients with definite, probable and possible tuberculous meningitis (TBM).
Table 2.
Laboratory and radiological investigation findings of patients with definite, probable and possible tuberculous meningitis (TBM).
Figure 2.
Kaplan-Meier survival curves of patients with definite, probable and possible tuberculous meningitis (TBM).
Survival probability at 6-months was similar between patients with definite TBM and those with probable TBM (log-rank test p = 0.69), and possible TBM (log-rank test p = 0.15).
Table 3.
Management and outcome of patients with definite, probable and possible tuberculous meningitis (n = 120).
Table 4.
Univariate analysis of variables associated with inpatient mortality in all patients with definite, probable and possible tuberculous meningitis (n = 120).
Table 5.
Univariate analysis of variables associated with inpatient mortality in HIV-infected patients with definite, probable and possible tuberculous meningitis (n = 106).
Figure 3.
Cox proportional hazard model survival curves.
ART: HIV-infected tuberculous meningitis (TBM) patients either on antiretroviral therapy (ART) at TBM presentation or started on ART during subsequent 6 months of antituberculosis (TB) treatment (n = 43). No ART: HIV-infected TBM patients not on ART at presentation nor started on ART during subsequent 6 months of TB treatment (n = 23). The model only included patients who survived hospitalization (n = 66). Hazard ratio for patients on ART = 0.30 (95% confidence interval 0.08–0.82, p-value = 0.03).
Table 6.
Univariate analysis of variables associated with six-month mortality in HIV infected patients with definite, probable and possible tuberculous meningitis (n = 56).1