DIAGNOSTIC-CRITERIA FOR TUBERCULOUS MENINGITIS AND THEIR VALIDATION

Setting: Tuberculous meningitis (TBM) has high morbidity and mortality . Demonstration of tubercle bacilli in cerebrospinal fluid (CSF), the only reliable method of diagnosis, is time consuming and has a low yie ld. Early diagnosis and treatment are of utmost importance for favoura ble outcome. Objective: The study was conceived to define easy to use criteria. Methods: A set of criteria using clinical features, CSF exam ination and computed tomography (CT) findings were defined. 76 patient s suspected of having TBM were divided into definite, highly probable, probable and possible TBM based on the criteria. The validity of crit eria was tested using information from bacterial isolation, polymerase chain reaction (PCR) test for tuberculosis, response to treatment and autopsy. Results: PCR was positive in over 75% of patients in the hig hly probable and probable groups. 91% of patients with highly probable and 66% with probable TBM improved on antituberculosis therapy. Concl usion: The criteria are reliable in making early diagnosis of TBM.