Tipu Sultan, Muhammad Akbar Malik, Malik Muhammad Nazir Khan, Tahir Masood Ahmed.
Clinical, laboratory and radiological indicators for the early diagnosis of Tuberculous Meningitis in children.
Pak Paed J Jan ;31(3):142-8.

Objective: To find out the clinical, laboratory and radiological indicators for early diagnosis of tuberculous meningitis in children. Design: Case series (prospective data) Place & duration of study: Department of Neurology Children`s Hospital, Lahore from March 1, 2005 to December 31, 2005. Subjects & Methods: Clinical data of 100 children treated as TBM (group A) admitted in the Neurology department, and another 100 children with diagnosis of meningitis, encephalitis or cerebral malaria (group B) was evaluated. History, clinical examination and relevant investigations were evaluated and Kenneth Jones criteria were applied to both groups. Results: Data of 100 children with TBM and similar number of controls was analyzed. Male to female ratio was 1.2:1. Clinically 77% children were in TBM stage III and 22% were in stage II and only one child was in stage I. There are number of variables including natural history of disease, serial CSF findings and brain immaging which had significant capacity for early diagnosis. Perhaps more studies are required to find out the efficacy of modified K J criteria. Conclusion: Tuberculous meningitis remains a serious health threat in developing countries. The variable (clinical features and laboratory investigations) of TBM had significant capacity for the early diagnosis if applied scientifically. There is an urgent need to improve diagnostic services at primary and secondary level to reduce the TBM stage III.

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