In order to assess the epidemiology, clinical features and outcome of tuber
culous meningitis, a retrospective review of patients was conducted between
January 1989 and December 1995, Forty cases (representing 10% of all paedi
atric patients with tuberculosis) were included. Mean age was 46 manfhs (ra
nge 1-165 months). Eighteen (45%) children were classified as stage I (non-
specific febrile illness without neurological signs), 16 (40%) as stage II
(neurological signs without marked changes in sensorium) and 6 (15%) as sta
ge III (major neurological signs with sensorial changes and/or coma). Twent
y-seven (67%) patients had received BCG vaccination and 14 (35%) displayed
an induration zone higher than 10 mm after a 2-TU PPD test. Mycobacterium t
uberculosis mas recovered from 24 (61%) patients. Hydrocephalus was demonst
rated by cranial computed tomography in 31 (78%) children. Overall, 18 (45%
) children had a full recovery. Mild, moderate and severe neurological sequ
elae were shown by 7 (18%), 3 (8%) and 9 (22%) of the patients, respectivel
y. Three fatal cases (7%) were observed. The presence of seizures (RR 15.6,
2.02-119.1) and absence of extrameningeal foci (RR 4.95, 1.10-22.1) were i
dentified as risk factors by multivariate analysis. These findings emphasiz
e the need quickly to diagnose tuberculosis in children in order to give ap
propriate and early treatment.