Preliminary report of directly observed treatment, short course in tuberculous meningitis

BACKGROUND: Diagnosis of tuberculous meningitis (TBM) is a challenge because of the manifold clinical presentation, and diagnosis is often delayed. OBJECTIVES: We wanted to share our experience of directly observed treatment short course (DOTS) in TBM. We did a retrospective analysis to look at the presentation, management and outcome of TBM patients from November 2006 to April 2008. MATERIALS AND METHODS: TBM was diagnosed based on clinical criteria. We excluded patients with HIV. RESULTS: We had 11 patients on DOTS regime. One died following hepatitis and another patient died of unrelated gastroenteritis. The only patient on daily regime died. Our patients generally presented late, at a median duration 20 days from onset of symptoms, and 50% had stage 3 disease at presentation. The median delay in diagnosis was 4.5 days. DISCUSSION: We found DOTS to be effective in TBM but not without side effects.