1634. Meningeal Tuberculosis: Experience of a Series of Cases from Cali, Colombia, 2008 - 2018

Abstract

BackgroundMeningeal tuberculosis (MTB) is the most lethal and disabling form of Mycobacterium Tuberculosis infection. In Colombia, it represents the second most frequent extrapulmonary location. Co-infection with the Human Immunodeficiency Virus (HIV) is one of the factors that most impacts their clinical results. Therefore, in this article we present the experience of 10 years of managing patients with MTB, with and without HIV coinfection.MethodsA retrospective observational study was conducted between January 2008 and December 2018, with clinical information from patients diagnosed with MTB at Teaching Hospital Fundación Valle del Lili. Using absolute and relative frequency tables, sociodemographic, clinical characteristics and treatment outcomes were described, according to HIV infection status. P values < 0.05 were taken as significant and 95% confidence intervals were used for comparison of proportions.Results61 patients with MTB diagnosed were enrolled. They represented 6.43% of all TB locations in the institutional registry. HIV coinfection was found in 26.2% of cases (n=16). Most of patients were men (65.6%), from urban areas (78.7%), and a median age of 39 years. Acute and subacute evolution of the infection was observed in half of the patients (50.8%). Also 85% presented some degree of neurological impairment. Bacteriological demonstration was achieved in 60.6% of all cases. 88% received drugs for sensitive TB, for a median of 9.5 months, and 52.5% received concomitant steroids drugs. Of the 36 subjects with information about their outcome, 42.6% were successful at treatment, 1 failed in the non-HIV group and 9 died (1 with HIV). 77% of all deaths were associated with TB.ConclusionMTB generates a significant burden disease. The characteristics of its insidious clinical presentation and the difficulty in achieving bacteriological demonstration in all patients make its timely diagnostic and therapeutic approach challenging.Disclosures All Authors: No reported disclosures