Tuberculosis Meningo-encephalitis in Casablanca, Morocco

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Published Aug 1, 2025
https://doi.org/10.62438/tunismed.v103i8.4987
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Vol. 103 No. 8 (2025): Tunis Med Aug 2025

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Jean Claude Majambere
Laboratory of clinical immunology, infection and autoimmunity, FMPC, Hassan II University, Casablanca, Department of Infectious and Tropical Diseases, CHU Ibn Rochd, Casablanca, Morocco.
https://orcid.org/0000-0002-5097-6082
Fatima Zahra Aznag
Department of Infectious and Tropical Diseases, CHU Ibn Rochd, Casablanca, Morocco.
Latifa Marih
Department of Infectious and Tropical Diseases, CHU Ibn Rochd, Casablanca, Morocco.
El Filali Marhoum Kamal
Department of Infectious and Tropical Diseases, CHU Ibn Rochd, Casablanca, Morocco.
Ahmed Aziz Bousfiha
Laboratory of clinical immunology, infection and autoimmunity, FMPC, Hassan II University, Casablanca, Morocco
Ahd Oulad Lahsen
Laboratory of clinical immunology, infection and autoimmunity, FMPC, Hassan II University, Casablanca, Department of Infectious and Tropical Diseases, CHU Ibn Rochd, Casablanca, Morocco.

Abstract

Introduction: Neuromeningeal tuberculosis remains the most serious form of Mycobacterium tuberculosis infection. The wide clinical polymorphism and lack of specificity of radiological signs make diagnosis difficult and lead to delays in management.


Aim: To describe the epidemiological profile of confirmed Tuberculous Meningo-encephalitis.


Methods: This is a monocentric, retrospective, descriptive and analytical study of patients followed for confirmed tuberculous Meningo-encephalitis in Infectious diseases department at the Ibn Rochd University Hospital in Casablanca between January 2015 and December 2018.  Analytical and multivariate logistic regression analyses were performed to identify predictors of mortality and neurological sequelae.


Results: 90 patients were included, 58% were male with an average age of 38 years. The main risk factors were low socioeconomic status (90%) and recent tuberculosis contact was observed in 13.3%. Onset of symptoms was progressive (92.2%) with average evolution of 25.4 days. Predominant clinical signs were fever (97.4%), headache (70%) and stiff neck (58%). Clinical forms were Meningo-encephalitis (59.9%) and meningitis (36.8%). Predominant Brain radiological sign was leptomeningeal contrast (35%). Cerebrospinal fluid (CSF) abnormalities: White cells mean: 128 white cells/mm3 with lymphocytic predominance (79.1%); Proteinorachia mean: 1.27g/l, Glycorrachia mean: 0.32g/l (88%). Culture on Lowenstein positive in 85% and RT- Polymerase Chain Reaction (PCR) performed in 17.7% and positive in 87.5%. All patients had received standard antituberculosis drugs combining Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. Evolution was favorable with symptom resolution patient rate of 62.5%, 10% mortality, 7.8% neurological sequelae. In multivariate analysis, delayed diagnosis, hydrocephalus and Meningo-encephalitis form were ...(abstract truncated at 250 words).

Keywords:

Tuberculous meningitis, Tuberculous Meningo-encephalitis, Mycobacterium tuberculosis

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