Characteristics | Patients, No. (%) | |||||||
---|---|---|---|---|---|---|---|---|
Total (n = 79) | Autoimmune (n = 1) | Viral (n = 1) | Bacterial, excluding TB (n = 10) | TB (n = 15) | Neoplastic (n = 8) | No definite diagnosis (n = 44) | P-value‡ | |
Age, mean, years | 37.3 | 39 | 18 | 35.1 | 29.7 | 57.4 | 37.2 | 0.00 |
Gender | ||||||||
male | 53/79 (67.1) | 1(100) | 1 (100) | 7 (70.0) | 8 (53.3) | 2 (25.0) | 34 (77.3) | 0.02 |
female | 26/79 (32.9) | 0 | 0 | 3 (30.0) | 7 (46.7) | 6 (75.0) | 10 (22.7) | |
Symptoms | ||||||||
Duration, mean, days | 32.7 | 30 | 6 | 59.3 | 33.5 | 31.1 | 25.9 | 0.70 |
Headache | 69/79 (87.3) | 1(100) | 1 (100) | 10 (100) | 14 (93.3) | 3 (37.5) | 40 (90.9) | 0.00 |
Fever | 44/78 (56.4) | 0 | 1 (100) | 5 (50.0) | 15 (100) | 1 (12.5) | 22 (51.2) | 0.00 |
Nausea/vomiting | 59/79 (74.7) | 0 | 1 (100) | 7 (70.0) | 12 (80.0) | 5 (62.5) | 34 (77.3) | 0.75 |
Neurological symptomsa | 31/79 (39.2) | 0 | 0 | 3 (30.0) | 9 (60.0) | 6 (75.0) | 13 (29.5) | 0.03 |
Visual impairment | ||||||||
Blurred vision | 23/79 (29.1) | 1(100) | 1 (100) | 4 (40.0) | 3 (20.0) | 3 (37.5) | 11 (25.0) | 0.41 |
Diplopia | 18/79 (22.8) | 0 | 0 | 4 (40.0) | 4 (26.7) | 3 (37.5) | 7 (15.9) | |
Photophobia | 3/79 (3.8) | 0 | 0 | 0 | 1 (6.7) | 0 | 2 (4.5) | |
Seizure | 11/72 (15.3) | 0 | 0 | 1 (11.1) | 3 (20.0) | 1 (12.5) | 6 (15.8) | 0.96 |
Night sweats | 5/79 (6.4) | 0 | 0 | 0 | 2 (13.3) | 0 | 3 (7.0) | 0.72 |
Weight loss | 6/79 (7.6) | 0 | 0 | 1 (10.0) | 2 (13.3) | 1 (12.5) | 2 (4.5) | 0.38 |
Dyspnea | 2/79 (2.5) | 0 | 0 | 0 | 0 | 0 | 2 (4.5) | 1.00 |
Cough | 5/79 (6.3) | 0 | 0 | 0 | 1 (6.7) | 1 (12.5) | 3 (6.8) | 0.80 |
Tinnitus | 1/79 (1.3) | 0 | 0 | 0 | 0 | 0 | 1 (2.3) | 1.00 |
Medical history | ||||||||
Immunosuppressionb | 2/79 (2.5) | 0 | 0 | 1 | 1 | 0 | 0 | - |
Malignancy | 8/79 (10.1) | 0 | 0 | 0 | 0 | 6 | 2 | - |
Signs | ||||||||
Altered mental status | 21/78 (26.9) | 0 | 0 | 1 (11.1) | 8 (53.3) | 3 (37.5) | 9 (20.5) | 0.57 |
Nuchal rigidity | 24/53 (45.3) | 0 | 0 | 6 (75.0) | 8 (72.7) | 0 | 10 (34.5) | 0.01 |
Papillary edema | 9/24 (37.5) | 1(100) | 0 | 2 (20.0) | 0 | 1 (12.5) | 5 (11.4) | 0.02 |
Laboratory analysis | ||||||||
WBC count, mean, × 109/L | 9.8 | 11.2 | 8.5 | 13.9 | 10.4 | 6.2 | 9.1 | 0.02 |
CSF analysis | ||||||||
WBC count, mean, cells/mm3 | 1248.3 | 40 | 740 | 8199.4 | 201.6 | 334.5 | 380.3 | 0.50 |
Pleocytosis | ||||||||
Neutrophilic | 24/62 (38.7) | 1(100) | 0 | 6 (100) | 2 (15.4) | 1 (25.0) | 14 (37.8) | 0.04 |
Monocytic | 34/62 (54.8) | 0 | 1 (100) | 0 | 10 (76.9) | 3 (75.0) | 20 (54.1) | |
Lymphocytic | 4/62 (6.5) | 0 | 0 | 0 | 1 (7.7) | 0 | 3 (8.1) | |
Elevated Protein | 49/67 (73.1) | 0 | 1 (100) | 6 (75.0) | 11 (91.7) | 4 (100) | 27 (65.9) | 0.24 |
Decreased glucose | 47/54 (87.0) | 1(100) | 0 | 5 (83.3) | 11 (100) | 3 (75) | 27 (87.1) | 0.43 |
Radiology | ||||||||
Normal Brain CT scan | 24/35 (68.6) | - | - | 3 (75) | 6 (60) | 1 (50) | 14 (73.7) | 0.75 |
Normal Brain MRI | 15/25 (60.0) | 0 | - | 2 (100) | 2 (33.3) | 1 (33.3) | 10 (76.9) | 0.02 |
Management | ||||||||
Steroid therapy | 30/79 (38.0) | 1(100) | 1 (100) | 2 (20) | 6 (40) | 7 (87.5) | 14 (31.8) | 0.06 |
Anti-TB therapy | 25/77 (32.5) | 0 | 0 | 0 | 15 (100) | 0 | 11 (25.6) | 0.00 |
Empirical acyclovir therapy | 23/64 (35.9) | - | 1 (100) | 3 (33.3) | 7 (46.7) | 2 (40) | 10 (29.4) | 0.53 |
Empirical antibiotic therapy | 55/60 (91.7) | - | 0 | 8 (100) | 10 (90.9) | 3 (60) | 34 (97.1) | 0.04 |
Death | 12/75 (16.0) | 0 | 0 | 1 (11.1) | 4 (26.7) | 1 (16.7) | 6 (14.0) | 0.65 |