Duration of Cyto-biochemical changes in CSF in children with TB Meningitis

Background: Tuberculous meningitis (TBM) remains a serious health threat for children in developing countries. This study was aimed to analyze findings and duration of cyto-biochemical changes in CSF in children with TBM. Patients and Method: Over a period of 8 years (1989-1996) we have analyzed cyto-biochemical changes in CSF in 202 children with TBM. In 126 cases (62,4%) was have analyzed duration of pleocytosis till the end of treatment. There were separately analyzed patients with favorable outcome 154 (76,2%) and patients with unfavorable outcome 48 (23,8%). Results: CSF cyto-biochemical changes in patients with unfavorable outcome were characterized with lower pleocytosis 234 cells/1mm [58-459]) (p<,0001) with lymphocytic predominance 79% [57-96%] (p<,0001) and greater elevation of CSF proteins 2,26g/L [0,96-4,48]) (p<,0001) while glucose level in CSF 1,59mmol/L [0,56-2,51]) was similar comparing to the cases with favorable outcome 1,49mmol/L [1,12-1,78] (p=0,092). Duration of pleocytosis lasted around 70 days [56-92]; significant number of children had pleocytosis till 4 months (12%) and 5 months (8,7%) while nonsignificant number of children had pleocytosis from 6-10 months 4 children (3,2%). Conclusions: Depending on duration of cyto-biochemical changes in CSF and not implementation of daily observed therapy we continue to support the twelve month therapy for TBM in children.