Tuberculous Meningitis: Multidrug-Resistant Disease Characterized in AIDS Patients

A report from University of Athens-Greece, has described "the clinical manifestations, bacteriologic characteristics, and outcomes for eight patients with multidrug-resistant tuberculous meningitis and AIDS."

Despite receiving TB treatment, the patients, all diagnosed with MDR-TB, "developed meningitis as a terminal complication of their TB disease. Seven patients presented with fever, five with headache, four with altered mentation, two with focal deficits, and one with seizures," according to the report, "Multidrug-Resistant Tuberculous Meningitis in Patients with AIDS," by G.L. Daikos and colleagues, published in the International Journal of Tuberculosis and Lung Disease (2003;7(4):394-398).

Researchers found pleocytosis, hypoglychorrhachia, and elevated protein levels in the patients' cerebrospinal fluid, and isolated "Mycobacterium tuberculosis resistant to at least isoniazid and rifampin" from all patients, according to the report. Three patients also had intracerebral mass lesions; three had hydrocephalus; the authors observed meningeal enhancement in five; and infarcts in two patients. Seven died between one and 16 weeks after they had been diagnosed with meningitis, and the eighth was lost to follow-up, according to the authors.