Clinico-radiological Profile of Tuberculous Meningitis and Mortality Predictors of Hospitalized Patients: An Ambi-directional Observational Study

Background: Tubercular meningitis is a common and fatal brain infection that has high mortality and morbidity in developing countries like India. The study aimed to evaluate clinical presentation, laboratory findings, and outcomes in patients who are suffering from tubercular meningitis. Methods: Retrospective data from January 1, 2021 to December 31, 2021 were collected from the Medical Records Department, whereas prospective data from January 1, 2022 to December 31, 2023 were obtained after informed consent. Patients ≥18 years diagnosed with tuberculous meningitis (TBM) based on Thwaites criteria were included. Exclusion criteria included incomplete data, lack of consent, and non-TBM diagnoses. Clinical, laboratory, and radiological parameters were assessed. Descriptive statistics summarize patient demographics and symptoms. Categorical variables were analyzed using Chi-square tests, and continuous variables were assessed using t -tests or Mann–Whitney U -tests. Multivariate logistic regression identified independent predictors of outcomes, with P < 0.05 considered statistically significant. Results: One hundred fifty-two patients were included in this study, with a mean age of 41.86 ± 17.79 years. Fever (96.7%) and altered mental status (86.2%) were the most common symptoms. Mortality was 40.8%, with higher rates in patients presenting with headache, AMS, Glasgow Coma Scale (GCS) <7 on day 1 ( P = 0.004), increased platelet count, and low cerebrospinal fluid (CSF) glucose levels ( P = 0.02). Other radiological findings included meningeal enhancement (69.7%) and hydrocephalus (33.6%). Conclusion: TBM presents with fever is the most common symptom, with a high mortality rate, especially in patients with low GCS and low CSF glucose.