J Korean Pediatr Soc.  1977 Jan;20(1):13-19.

Clinical Review of Tuberculous Meningitis in Children

• Hwang YS
• Yun CK
• Ko KW

Abstract

The following results were obtained through the clinical review of 89 cases of tuberculous meningitis which were treated at the Department of Pediatrics of Seoul National University Hospital during the period of 3 years from June 1973 till May. 1976. 1. The highest incidence by age was noted as 80.9% under the age of 6years and 24.7% of cases were between the age of 1 and 2 years, Male to female ration was 1.2:1. 2. 35%of cases were noted in the spring 28%, in the summer, 19%, in the autumn and 18% in the winter. 3. The chief complaints on admission were in the order of vomiting, Fever, convulsion, drowsiness and headache. Meningeal irritation sign was noticed in 80.9% of cases . 4. Tuberculin test revealed positive reaction in 72.1%of cases. 5. Clinical stage on admission revealed 35cases of stage I. 1cases (2.9%)died and 30cases(85.7%)recovered. Stage II was 32cases and 6cases(18.8%)died and 14cases (43.8%) recovered. Stage III was 32cases and 7cases (31.8%) died and only 3cases (13.6%) recovered. Overall mortality was 15.7% 6. Family history of tuberculosis was found in 29 cases (32.5%) 7. Chest X-ray revealed tuberculous lesions in 59.5%of all cases and miliary tuberculosis were found,. In 20.2%of all cases. 8. Mean leukocyte count in the cerebrospinal fluid was 261/mm3 and 80.2% of all cases were in the range of 50~500/mm3, in 75.3% of all cases, differential count of lymphocyte was over 75%. Mean protein level in the cerebrospinal fluid was 170mg%and 91.5% of all cases were in the range of 50~300mg%. Sugar level in the cerebrospinal fluid was decreased below 40mg% in the 73.2% of all cases and the mean was 31.7%. Mean chloride level was 112.1mEq/l and 93.1% of all cases were below 120mEq/l. 9. Mortality rate was slightly lower in the group treated with triple therapy and corticosteroid than the group treated with only INH, PAS, and SM.

MeSH Terms

Cerebrospinal Fluid
Child*
Female
Fever
Headache
Humans
Incidence
Leukocyte Count
Lymphocytes
Male
Mortality
Pediatrics
Seizures
Seoul
Sleep Stages
Thorax
Tuberculin Test
Tuberculosis
Tuberculosis, Meningeal*
Tuberculosis, Miliary
Vomiting