Complications of tuberculous meningitis and their effect on outcome in a tertiary care cohort

Figure 1 Cranial imaging showing various
complications of TBM in a 35-year-old male. The patient had fever and headache
for 4 months. CSF analysis revealed 105 mg/dl protein, 95 lymphocytic/mm3
and positive Xpert results. He was prescribed four-drug ATT. After 15 days, the
patient became drowsy; CT revealed communicating hydrocephalus and thalamic
infarction (not shown). A) After ventriculo
peritoneal shunt, the patient improved. His MRI 15 days later revealed increased
exudate, tuberculoma and cerebral salt wasting. B) Fifteen days later, he needed mechanical ventilation for 2 days and
had altered liver functions (serum alanine amino transaminase 118 U/L,
bilirubin 1 mg/dl). TBM = tuberculous meningitis; CSF = cerebro-spinal fluid;
ATT = anti-tuberculosis treatment; CT = computed tomography; MRI = magnetic
resonance imaging.

Figure 2 Kaplan-Meier
graphs show there was significantly longer survival in patients without infarct
(P = 0.004), seizure (P = 0.004), hyponatremia (P = 0.018), paradoxical worsening (P = 0.001) and mechanical ventilation (P = 0.001).