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SettingCentre for Tropical Diseases, a 500-bed hospital for infectious diseases in Ho Chi Minh City, Vietnam.ObjectiveThe factors that determine outcome in adults with tuberculous meningitis are poorly understood. The objective of the study was to investigate the relationship between admission clinical features, HIV infection, drug resistance, mycobacterial genotype and outcome in adults with tuberculous meningitis.DesignClinical and laboratory data were recorded prospectively for 56 Vietnamese adults with tuberculous meningitis confirmed by culture of cerebrospinal fluid. Variables associated with in-hospital mortality, IV infection, drug resistance and microbial genotype were assessed by univariate and multivariate analysis.ResultsAdmission coma score independently predicted death in hospital (OR 0.73, 95%CI 0.61-0.87, P = 0.001). HIV-infected adults with tuberculous meningitis were more likely to be infected with Mycobacterium tuberculosis resistant to isoniazid (P = 0.011) and streptomycin (P = 0.002). Isoniazid resistance, streptomycin resistance, HIV infection and microbial genotype were not associated with increased in-hospital mortality.ConclusionTreatment of tuberculous meningitis before the onset of coma saves lives. Resistance to isoniazid and/or streptomycin does not appear to affect outcome.



The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease

Publication Date





865 - 871


Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, UK.


Lung, Sputum, Humans, Mycobacterium tuberculosis, Tuberculosis, Meningeal, HIV Infections, Isoniazid, Antitubercular Agents, Prospective Studies, Drug Resistance, Bacterial, Genotype, Adolescent, Adult, Middle Aged, Vietnam, Female, Male, Outcome Assessment, Health Care