Affiliations: Department of Pediatrics, Chhatrapati Shahuji Maharaj
Medical University, Lucknow, India | Department of Radiodiagnosis, Chhatrapati Shahuji
Maharaj Medical University, Lucknow, India | Department Microbiology, Chhatrapati Shahuji Maharaj
Medical University, Lucknow, India
Note:  Correspondence: Prof. Rashmi Kumar, Department of Pediatrics,
Chhatrapati Shahuji Maharaj Medical University, Lucknow (UP) 226003, India.
Tel.: +91 522 2322577, 9415408777; E-mail: [email protected]
Abstract: Tuberculous meningitis (TBM), the severest form of tuberculosis,
continues to affect children in India. The disease has a high rate of mortality
and disabling consequences. Scarce literature exists on prognostic indicators
in children and none on radiological prognostic features. Our aim is to
delineate clinical, laboratory and radiological prognostic indicators in
childhood TBM. Children with TBM diagnosed according to pre-decided criteria
and admitted to a teaching hospital in Northern India were enrolled for study.
Demographic, clinical, laboratory and radiologic features at admission were
charted. Patients were followed up to 3 months from discharge or until death.
Features at admission were compared between those with good and bad outcome by
univariate and logistic regression analysis. A total of 53 of 68 enrolled
children were followed for 3 months. Significant factors on univariate analysis
were age, headache, Glasgow coma score (GCS), muscle tone, extensor plantar
response, decerebrate posturing, clinical stage of disease and infarcts on
computerized tomography scan head. On logistic regression, only age ⩽ 3 yr,
GCS < 10 and increased muscle tone were significantly associated with bad
outcome. Younger age, lower GCS and increased muscle tone at initial diagnosis
are significant independent predictors of bad outcome in TBM in children.
Keywords: Tuberculous meningitis, logistic regression, prognostic indicators, Glasgow coma scale