ICNC Abstracts, ICNC 2018

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YIELD OF GENEXPERT AND OUTCOMES IN PEDIATRIC TUBERCULAR MENINGITIS
Lokesh Lingappa

Last modified: 2018-09-09

Abstract


INTRODUCTION

Tubercular meningitis (TBM) is the most life threatening manifestation of tuberluosis with high degree of mortality and morbidity.

Aims and objectives:

To study the Clinical profile, Radiological  findings, yield of GeneXpert and outcome of TBM  among children.

Material and Methods

Total 36 children with tubercular meningitis were included in the study from January 2015 to June 2018. Clinical , laboratory profile and treatment outcomes recorded. Stastics with SPSS 20th version.

 

RESULTS

Mean age was 36 months. 14 (38%) had definitive TBM, 20 (56%)  probable TBM and 2 (6%)  possible TBM. Majority  had fever, altered sensorium, headache, seizures. Hemiplegia in 76%, Cranial nerve palsy in 53%. CSF –GeneXpert was positive in 38%. Hydrocephalus and basal exudates (75%) being the most common radiological finding. Surgical intervention performed in  14/26 children with hydrocephalus. Ommayya reservoir was placed in 7/14 children out of which 7 children needed VP shunt and  in  5/14 direct VP shunt was placed. Three patients died. 78% had good outcome and 22% had poor outcome at discharge according to Modified Glasgow outcome scale.  One each had spinal arachnoiditis, Bickerstaff encephalitis and PAID syndrome. Stage III disease, low GCS at presentation and cerebral infarcts were associated with poor outcome. Learning difficulties with poor scholastic performance was evident in 4/17 (23.5%) of  school going children at follow up.

 

CONCLUSION

CSF GeneXpert yield was only 38% of our cases. 50% with hydrocephalus were managed conservatively.


Keywords


tubercular meningitis, hydrocephalus, Gene Xpert

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