1424. Central Nervous System Tuberculosis in a Large Healthcare System

Abstract Background Central nervous system tuberculosis (CNS-TB) accounts for 5-10% of extrapulmonary TB cases. It takes 3 clinical forms: meningitis, tuberculoma, and arachnoiditis. Modern case descriptions the presentation CNS-TB are rare. The goal this study is to examine presentation, diagnostic studies, associated comorbidities CNS-TB. Methods In our academic healthcare system, cases culture confirmed were identified in a database maintained by infection control group. This retrospective series 11 adults with Results 273 patients from 2008 2022. 104 (38%) had extra pulmonary disease. (4%) CNS infection. Patient characteristics described Table 1. 5 (45%) disease also Mean age diagnosis was 42. male 9 (82%) African American. HIV; mean CD4 count 100 (8-255). Diagnostics shown 2. CSF studies revealed WBC 295/mm3 (4-808), protein 605 mg/dL (27-4476), Glucose 31 (12-64) mg/dL. 4 (36%) presented British Research Medical Council (BMRC) stage I 7 (64%) II 8 (73%) an abnormal CT or MRI scan head, representative images seen Figure lesions consistent tuberculomas. 1 (9%) arachnoiditis on imaging. patient died. Conclusion 38% diagnosed at center compared 17.5% reported literature. 4% rate similar previously reported. Our describes imaging as well showing leukocytosis, pleocytosis, hypoglycorrhachia findings. Though numbers small, no significant difference found between HIV positive negative patients. Although mortality rare series, who died advanced AIDS multidrug resistant meningitis. Given global disease, highlights need more current describing modern so clinicians can better recognize treat condition without delay. Disclosures All Authors: No disclosures.