TUBERCULOUS MENINGITIS, ABBASSIA-FEVER-HOSPITAL - NAVAL MEDICAL-RESEARCH UNIT NO. 3 - CAIRO, EGYPT, FROM 1976 TO 1996

A total of 1,430 patients with the presumptive diagnosis of tuberculou s meningitis were admitted to the U.S. Naval Medical Research Unit No. 3/Abassia Fever Hospital in Cairo, Egypt from January 1976 to January 1996. Diagnosis was confirmed by culture of the mycobacteria from the cerebrospinal fluid CSF of 857 patients and these patients are includ ed in the final analysis. There were 497 males and 360 females, The pa tients ranged in age from five months to 55 years. The number of patie nts admitted during the months of March, April, and May were more than double those admitted during October, November, and December. The dur ation of symptoms prior to admission ranged from seven to 90 days (mea n = 29.5 days). Upon admission, 4% of the patients were alert, 34% wer e drowsy, and 62% were in a coma. Of the 857 patients studied, 490 (57 %) died, 256 (30%) recovered completely, and 11 (13%) recovered with s equelae. The mortality and neurologic sequelae were directly related t o the stage of disease and duration of symptoms prior to admission. Mo rtality was significantly lower in patients admitted in stage 11 and o r with short duration of disease compared with those in stage III and or with prolonged duration of symptoms prior to admission. The use of dexamethasone in patients with tuberculous meningitis significantly re duced the ocular complications that occur in these patients and also s ignificantly reduced the fatality rate.