| Objective:To investigate the clinical features,cerebrospinal fluid(CSF) changes,imaging characteristics,diagnostic methods,treatment regimens and outcomes of Chinese adult patients with tuberculous mengingitis(TBM).Methods:Clinical data of 50 cases of TBM admitted to Second Affilitated Hospital of Chongqing Medical University from January 2002 to October 2007 were investigated restrospectively.Data were collected with regard to the clinical,laboratory and demographic characteristics of the patients as well as the results of radiological investigations and data of clinical outcome.Results:Fifty TBM cases were included in this study;there were 23 males and 27 females.Three cases were definitely diagnosed through brain or lymph node biopsy,the remaininig 47 cases were diagnosed clinically.Headache(92%),fever(78%),vomiting(68%),meanigeal irritation and impairment of cranial nerve function were the most frequent symptoms and signs.Forteen cases were accompanied with phthisis miliaris and 10 cases with exudative pulmonary tuberculosis. Raised intracranial pressure was present in 58%,CSF was non-purulent with lymphocytic pleocytosis,midrange elevation of protein concentration and decrease of glucose and chloridate. Forty-three cases had imaging data;abnormities were found in 31 with infarction,ventricular enlargement,hydrocephalus and tuberculoma the most frequent findings.All the patients received anti-tuberculosis therapy,two cases undertaked focus clearance.Forty improved and one died.Conclusion:TBM should be suspected when chronic mengingitis was accompanied with active pulmonary or extrapulmonary tuberculosis.Differential diagnosis and trial anti-tuberculosis therapy may be of help for the diagnosis.Postive CSF smear and culture and biopsy of brain or meninges are the golden standards for the diagnosis of TBM.Early diagnosis and treatment are very important for improving the outcome.
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