Clinical profile in chronic meningitis patients: A prospective study at tertiary care center

 

 

Abstract              Background: Early diagnosis and appropriate therapy of chronic meningitis is important in improving the overall outcome and to prevent long-lasting sequels. As many etiological agents lead to the development of chronic meningitis, it is important to develop a systematic approach to the diagnosis; taking clues from history, examination and laboratory tests, to make an accurate diagnosis and institute appropriate therapy. Aim: To document clinical profile and diagnostic modalities of patients with chronic meningitis. Material and Methods: A total of 90 patients with chronic meningitis were included. Clinical features were noted and CNS examination was done and investigations such as Gene X-pert-CBNAAT, Chest X-Ray, CSF analysis, Computed Tomography Scan and Magnetic resonance imaging were done. Results: Among the 90 patients in this study, the common initial presenting symptoms were fever, headache, neck stiffness and altered sensorium. Fever was the most common initial presenting symptom. 73 patients (81.1%) had fever and 66(73.3%) patients had headache. Most common etiology of the chronic meningitis in the study was tuberculous meningitis with 65 (72.2%) patients. There was a single patient of Aspergillus and 2 patients of bacterial meningitis. Number of deaths was highest in TB meningitis (10.77%) and the proportion of the mortality was highest in viral meningitis(18.75%) cases. Conclusion: Chronic meningitisis an important neurological disease. Although most patients require clinical evaluation and CSF analysis, CT scan and Gene X-pert (CB-NAAT) study of CSF is also necessary to rule out structural intracranial lesions and tuberculous meningitis.

Key Word: Chronic meningitis, symptoms, tuberculous meningitis, Gene X-pert (CB-NAAT), outcome