M V Narasimham

Abstract

Background: Meningoencephalitis refers to the inflammation of the meninges and brain, and is considered an infectious neurological emergency. Tuberculous meningoencephalitis is caused by Mycobacterium tuberculosis and is the most common form of central nervous system (CNS) tuberculosis. Materials and Methods: CSF samples were collected asceptically and processed with an aim to identify and isolate Mycobacterium tuberculosis from clinically suspected cases of meningoencephalitis and observe the antitubercular drug resistance pattern. Results: The study group included 117 patients clinically diagnosed cases of chronic meningoencephalitis which were subjected to Z-N staining, culture on LJ media. From 117 cases, 21 cases were AFB positive,  20 cases were culture positive for Mycobacterium tuberculosis. Antitubercular drug susceptibility pattern was obtained using commercial kit provided by Himedia. (SL023) Conclusion: Tuberculous meningoencephalitis associated with a high frequency of neurologic sequelae and mortality if not treated promptly. Keywords: Meningoencephalitis, Mycobacterium tuberculosis, Anti tubercular drug susceptibility.

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Abstract

Background: Over 1.2 million cases of bacterial meningitis are estimated to occur worldwide each year. World Health Organization (WHO) estimated 9 million people developed tuberculosis in 2013, and 1.5 million died. Tuberculous meningitis (TBM) is still one of the common infections of central nervous system (CNS) and poses significant diagnostic and management challenges, more so in the developing world. The main reason for the spread of tuberculosis is poverty, with resulting  homelessness, overcrowding, malnutrition, HIV, excessive alcohol use, diabetes and breakdown of public health infrastructure. Materials and Methods: CSF samples were collected asceptically and processed with an aim to identify and isolate Mycobacterium tuberculosis from clinically suspected cases of chronic meningoencephalitis and compare their conventional and molecular methods of diagnosis. Results: The study group included 197 patients clinically diagnosed as meningoencephalitis. Out of which, 117 had features of chronic meningoencephalitis and were subjected to Z-N staining, culture on LJ media and CBNAAT testing. From 117 cases, 21 cases were AFB positive, 20 cases culture positive and 36 cases were positive for Mycobacterium tuberculosis. Conclusion: CBNAAT (molecular testing) is a better diagnostic tool for diagnosing tuberculous meningitis. Keywords: Meningoencephalitis, Mycobacterium tuberculosis, CBNAAT.

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