Etiology | Thwaites Scoring Classificationa | Lancet Scoring Classificationb |
|---|
(n = 395) | ≤4 points (Possible TBM) | > 4 points (Possible BM) | Definite TBM Positive TB Culture | Probable ≥12 points | Possible 6─11 points | No TBM < 6 points |
|---|
TBMc (162) | 160 | 2 | 162 | 81 | 81 | 0 |
Fungald (41) | 41 | 0 | 0 | 5 | 35 | 1 |
Virale (29) | 29 | 0 | 0 | 0 | 28 | 1 |
Bacterialf (7) | 6 | 1 | 0 | 0 | 7 | 0 |
Miscellaneousg (16) | 16 | 0 | 0 | 6 | 10 | 0 |
Unknownh (140) | 139 | 1 | 0 | 14 | 123 | 3 |
- aIf a patient has a total score of 4 or less, the patient is classified as tubercular meningitis (TBM) and a score of more than 4 is suggestive of bacterial meningitis
- bDefinite diagnosis of TBM is made if there is evidence of Acid Fast Bacilli (AFB) in CSF smear, culture or on histopathology of brain or spinal cord. A probable diagnosis is made if the total score is >10 points if patients have no imaging, or >11 points if imaging was used. A possible diagnosis is made with scores between 6-9 points without imaging or 6-11 with imaging. No TBM if the total score < 6 points
- c162 cases of CSF Culture positive for TB Complex, although all 162 cases are definite TBM , we calculated the actual Lancet score
- d36 cases of Cryptococcal Meningitis , 3 cases Coccidiosis Meningitis, 2 cases of Histoplasma Meningitis
- e10 cases of Herpes simplex 1 & 2, 8 cases of West Nile Virus, 4 cases of Varicella Zoster Virus, 3 cases of Saint Louis Virus, 2 Cases of Enterovirus, 2 cases of acute HIV
- f3 cases of Streptococcus pneumoniae , 1 case of Methicillin Sensitive Staphylococcus Aureus , 1 case of Haemophilus influenzae , 1 case of Group A Streptococcus , 1 case of coagulase negative staphylococcus
- gMiscellaneous etiologies includes: non-infectious etiologies: 5 cases of Systemic lupus erythematosus meningoencephalitis, 2 cases of para neoplastic (1 case due Breast cancer, 1 case due to anti NMDA), 2 cases of Neurosarcoidosis, 1 case of Meningeal Carcinomatosis, 1 case of disseminated encephalomyelitis (ADEM), 1 case of Central Nervous System Lymphoma. Parasitic infections etiologies: 2 cases of Cerebral Toxoplasmosis, 2 cases of Neurocysticercosis
- hUnknown cause of meningitis
