|
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
