Tuberculous meningitis: A follow-up study on 198 cases

Abstract

Since tuberculous meningitis became a treatable many reports have appeared in the literature detailing survival rates, and special features such as the late complications. It seemed important to add to these a study of the quality of recovery in a large unselected group of patients, and to report on their progress during prolonged follow up, with special emphasis on their ability to lead normal lives or otherwise. The results in this series of 198 patients are most encouraging; the majority recovered well, and have remained well for periods of up to 15 years, leading lives normal in every way (122 patients), or only minimally restricted (42 patients); and the series includes 91 surviving patients treated when streptomycin was the only available chemotherapy. Twenty four of the 25 children surviving since the introduction of isoniazid are leading unrestricted lives at normal schools. The incidence of relapse in patients treated after the so-called experimental era is insignificant (4 cases, in 3 of which our accepted criteria for adequate treatment were not observed for special reasons). The particular features of the treatment used throughout this series are that it is prolonged, and administered by combined systemic and intrathecal injection, and that PPD is used as the adjuvant to chemotherapy. It is considered that the results obtained by this regime justify its nature.