Correlation of clinical, laboratory and drug susceptibility profiles in 176 patients with culture positive TBM in a tertiary neurocare centre

- Correlation of 9 clinical and 6 laboratory features in Definite TBM patients.
- MGIT has the advantage over conventional LJ in the yield and duration.
- Immune response and chloride in the CSF as an adjunct to the rapid diagnosis.
- Significant differences noticed in clinical and laboratory features between drug-resistant and drug-sensitive patients.
- Study provides data for improvement of diagnosis and timely treatment of tuberculous meningitis.

Drug resistance has increased the difficulties in control of tuberculosis infection. The present study evaluated the clinical and laboratory features among tuberculous meningitis (TBM) patients and the drug susceptibility of Mycobacterium tuberculosis (M.tb) isolated from CSF. Out of 698 CSF samples, 176 (25.21%) were M.tb culture positive. Among the clinical signs and symptoms, fever, headache and altered sensorium were found to be statistically significant (P < 0.05). ELISA was a better predictor of disease and found to be statistically significant (P < 0.001) in culture-proven TBM cases. Totally, 57 (32.4%) isolates were resistant to one or more drugs that include 5 (2.8%) multidrug-resistant isolates. In conclusion, the search for antibody in CSF and also CSF chloride can represent as an adjunct in the diagnosis of TBM. Screening of drug susceptibility is a very important factor and would help in better management of the disease.