Publication:

Clinical profile of tuberculous meningoencephalitis in pediatric patients at a tertiary care center

Background Tuberculous meningoencephalitis (TBME) is the most severe form of childhood tuberculosis and is associated with high mortality and long-term neurological sequelae. Despite availability of effective anti-tubercular therapy, delayed diagnosis, malnutrition, and poor immunization status continue to adversely affect outcomes in children.

Methods This prospective observational study was conducted from January 2023 to June 2024 in the paediatric wards and pediatric intensive care unit of a tertiary care centre in western India. Children aged 1 month to 12 years diagnosed with TBME were included. Detailed clinical evaluation, laboratory investigations, neuro imaging, Bacillus Calmette–Guérin (BCG) vaccination status, nutritional status, complications, and outcomes were recorded using a pre-structured proforma.

Results A total of 75 children with TBME were studied. Majority of patients (68%) were below five years of age. Fever, seizures, vomiting, and altered sensorium were the most common presenting features. BCG-vaccinated children had milder disease and better outcomes. Malnutrition was significantly associated with advanced disease stage, increased complications, and poor neurological outcome. Hydrocephalus was the most common complication. Mortality was higher in children with severe malnutrition and advanced stage of disease.

Conclusion TBME remains a serious and life-threatening illness in children. BCG vaccination and good nutritional status play a protective role. Early diagnosis, prompt initiation of antitubercular therapy, and aggressive management of complications are essential to reduce morbidity and mortality.