F.G. Youssef  , S.A. Afifi  , A.M. Azab  , A.O. Saeid  , T.M. Parker  , 
    Emergence of Tuberculous Meningitis in Egypt as an Important Public Health Problem During a Five-Year Surveillance (1998-2003),
    International Journal of Tropical Medicine,
    Volume 2,Issue 1,
    2007,
    Pages 16-20,
    ISSN 1816-3319,
    ijtmed.2007.16.20,
    (https://makhillpublications.co/view-article.php?doi=ijtmed.2007.16.20)
    Abstract: Tuberculous meningitis, one of the most common chronic infections of the central nervous system, had emerged as a significant cause of meningitis in Egypt. In this study we assess the epidemiology, clinical characteristics, mortality and laboratory features of tuberculous meningitis in patients during the enhanced meningitis surveillance 1998-2003. Retrospectively, we reviewed the data of 134 immunocompetent patients with culture positive <I>Mycobacterium tuberculosis</I> infection. The overall case fatality rate for patients with tuberculous meningitis was 47%. It was significantly higher (p< 0.001), than that for all other causes of bacterial meningitis (21.3%). The median age of cases was 23 years. They were 49.6% males and 57.5% of cases occurred in patients>20 years of age. The characteristic cerebrospinal fluid findings, included moderately elevated leucocytes  count  (median:  175  mm <SUP>3</SUP>),  decreased glucose (median: 30 mg dL <SUP>1</SUP>), elevated protein (median: 105 mg dL <SUP>1</SUP>) and proportion of lymphocytes % (median: 30). Patients had long prodromal period>5 days (65%) and low or moderate grade fever (= 38°C) was found in 70%.  Tuberculous meningitis has emerged as a significant cause of bacterial meningitis in Egypt.  Rapid diagnosis and earlier initiation of therapy is important to avoid the high risk of mortality or disabling neurologic sequelae.
    Keywords: Mycobacterium tuberculosis meningitis;epidemiology and clinical features of TBM;TBM in Egypt;clinical and laboratory features of TBM