Tuberculosis meníngea : caracterización y georreferenciación de casos atendidos en el Hospital Universitario Méderi 2012-2016

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Butrón Granados, Natalia Carolina; Jiménez Herrera, María Paula; Especialista en Epidemiología (en Convenio con el CES)
Facultad de medicina
Meningitis aséptica; Meningismo; Tuberculoma; Infecciones oportunistas; 616.82; Asceptic meningitis; Meningism; Oppertunistic infections
thesis / dissertation description
Background: Meningeal tuberculosis presents a challenging diagnosis, which delays the initial treatment and worsens the patient's prognosis and outcome. In Colombia there are few studies in relation to the high prevalence presented of the pathology. Objectives: Characterize clinical, imagenological and sociodemographically, patients with meningeal tuberculosis at the Mayor University Hospital in Bogotá D.C, between 2012-2016. Method: Descriptive, retrospective study, with application of the georeferencing method from cases reported with meningeal tuberculosis in the Mayor University Hospital from 2012-2016. Results: a total of 27 patients were reviewed, with a median age of 47 years, predominantly male, without coinfection with HIV. The main reason for consultation was altered consciousness followed by headache, with a mean time of evolution of the symptoms of 10 days. The main finding in the first neuroimaging (CT) was hydrocephalus, which is a nonspecific finding. A mortality of 50% was found. Discussion: The sociodemographic characteristics found were congruent with those reported by WHO. Up to one third of patients showed an acute presentation despite what is reported internationally. A higher mortality was observed in the group of patients who exhibit focalization, suggesting this, as a potential risk and prognosis factor. The neuroimaging of choice for diagnosis should be the MRI, since the CT is reported normal or with nonspecific findings in 30% and 50% of the cases respectively. Finally, the start of tetra conjugate therapy was delayed in 51.8% of the cases, which could be associated with the high mortality rate.