[Tuberculous meningitis in children. Study of 34 cases (author's transl)].

Thirty four cases of tuberculous meningitis in children of 6 months to 8 years of age are reviewed. Maximum frequency (44% of the cases) correspond to 0.5 to 2 year age group. In 55.8% of the cases symptoms appeared less than 20 days before admission to hospital. On admission 24% of the cases were in stage I, 64.7% in stage II and 11.7% in stage III according to the criteria of the Medical Research Council. None of the patients had been vaccinated with BCG. a family history of active tuberculosis was shown in 29.4% of the cases. "Mycobacterium tuberculosis" was isolated from spinal fluid in only 20.5% of the cases. A positive Mantoux was found in 70.5% and 50% showed a pathological chest X-ray film. A triple-drug therapy was instituted immediately after diagnosis. First choice drugs were streptomycin, rifampicin and isoniazid. Average length of treatment was 21 months. Corticosteroids were given to 17 children. Most frequent complications were convulsions, hydrocephalus, ophthalmoplegia, hyponatremia and hepatotoxicity due to rifampicin. Mortality rate was 14% and 55% of the survivors developed sequelae. Relations between precocity of diagnosis, therapeutic protocol and evolution are discussed. Importance of early diagnosis is stressed.