Tuberculous meningitis in adults: a four-year review during 1997-2000.

We reviewed the charts of all HIV-negative patients 15 years of age or older in whom tuberculous meningitis was diagnosed and treated without corticosteroids at Srinagarind Hospital, Khon Kaen, Thailand during the period of 1997-2000. Forty-five patients were included in this study. The clinical manifestations were subacute to chronic meningitis and they presented in stages 1 and 2, except one case which was in stage 3. All patients were treated with a 6-month course of chemotherapy with good clinical outcomes. The mortality rate was 2.2% and the percent of residual neurological deficits after treatment was 6.7%. The review showed the good clinical outcomes can be had without adjunctive corticosteroid.

Streptococcus sanguis meningitis: report of a case.

A 35-year-old woman who presented with acute purulent meningitis and hearing loss was reported. No bacteria was seen with Gram' s stain of cerebrospinal fluid (CSF). CSF grew Streptococcus viridans, which was subsequently identified to be S. sanguis. The patient improved after treatment, including hearing.

Actinomycotic meningitis: report of a case.

A 73-year-old man who presented with acute fever, drowsiness and confusion was reported. Two weeks prior to admission, he attended the Outpatient Department with symptoms of fever and headache for 2 weeks. Eosiophilic meningitis was initially diagnosed, which, in fact, was lymphocytic CSF pleocytosis. He was treated with a high dose of prednisolone. His symptoms improved for 1 week, then he experienced symptoms of fever and headache again. On admission, he had stiffness of the neck. Lumbar puncture showed purulent CSF with gram-positive branching filamentous organisms. CSF grew Actinomyces israelii. The patient died from brain herniation.