Treatment of Tuberculous Meningitis: Role of Short-course Chemotherapy

Twenty-eight adult patients admitted consecutively with tuberculousmeningitis were treated with pyrazinamide, isoniazid, rifampicinand streptomycin daily during the first two months, followedby isoniazid and rifampicin daily for seven months with intensivemanagement of the complications during the active stage of themeningitis. Twenty-two patients completed the course of treatmentand recovered with minimal morbidity in three patients. Twopatients died in a vegetative state from other causes sevenand nine months after the start of treatment. No evidence ofrecurrence of meningitis was observed in the 21 patients whowere regularly observed for 12 to 29 months after completingtreatment. Four patients dropped out during the early stageof treatment. Intensive chemotherapy of tuberculous meningitiswith this regimen before the development of serious neurologicaldamage can shorten the duration of treatment to nine monthswith a favourable outcome.