Classification of tuberculous meningitis using Marais Criteria

Abstract

Background: Tuberculous meningitis (TBM) diagnosis is difficult, being the worst prognostic form of extrapulmonary tuberculosis. Diagnostic delays contribute significantly to mortality and neurologic sequelae.

Methods & Materials: We performed an observational, descriptive and transversal study applying new consensus criteria for the definition of Meningeal Tuberculosis diagnosis and British Medical Research Council stage prognosis. In the study period, 68 patients were identified for tuberculous meningitis, 40 were excluded, and the final sample consisted of 28 cases

Results: The diagnostic group “Possible” was the most common with 35.7%, followed by Definite with 28.6%, Probable 21.4%, and 14.3% were excluded as Non-tuberculous meningitis in which an alternative diagnosis was established or considered dual disease. 60.71% were less than 5 years of age. 78.6% were male. 80.77% patients had symptoms for more than 5 days. 88.46% patients had focal neurological deficits. 64% patients showed alteration of consciousness. 64.3% underwent neuroimaging, which 50% demonstrated hydrocephalus. 75% of patients were in Stage III of the prognostic British Medical Research Council classification. 7.1% died.

Conclusion: Classification of tuberculous meningitis allows early diagnosis and treatment. Tuberculous meningitis manifestations vary and TBM is usually diagnosed when brain damage has already occurred.