Clinical and diagnostic characteristics of meningeal tuberculosis in adults, Bogota (Colombia)

Introduction: Infection with Mycobacterium Tuberculosis is a worldwide disease whose main clinical manifestation is pulmonary, meningeal tuberculosis is the second most common extra-pulmonary presentation after pleural represents a high morbidity and mortality, early diagnosis and treatment reduces these outcomes. Objective: The aim of the study was to establish the clinical characteristics of patients with meningeal tuberculosis in our institutions and evaluation of the results obtained with the diagnostic methods available. Materials and methods:A descriptive cross-sectional study was conducted by reviewing the medical records of patients with meningeal tuberculosis; in the period between 2003-2012, two institutions third and fourth level of care in Bogotá. Results: 36 patients with meningeal tuberculosis, with a mean age of 52.4 years, 63.8% male, 16.6% coinfection with human immunodeficiency virus were evaluated. The subacute and chronic clinical presentation was 49.9%, 86.1% had headache, other symptoms were fever, neck rigidity, among others. In cerebrospinal fluid protein levels were 100%, 88.8% hypoglycorrhachia. 71.8% in microbiological studies were positive adenosine deaminase, 30.4% positive chain reaction polymerase and 41.1% positive culture. Hyponatremia was 36.1%. In neuroimaging, 18.7% and 17.6% had hydrocephalus Pachymeningitis. Conclusion: The meningeal tuberculosis today represents a diagnostic challenge because there is no method available with the ideal characteristics of a diagnostic test, having considered the clinical manifestations of subacute or chronic meningitis and cerebrospinal fluid findings in primary for diagnosis and initiation early treatment.