Comparative Analysis of Complications in Meningitis Patient Tuberculous vs. Bacterial

Objective:  This comparative analysis aims to evaluate the patterns of radiological complications in bacterial meningitis against those seen in tuberculous meningitis. Materials and Methods:  A retrospective review of imaging and clinical data was conducted. The frequency of complications such as hydrocephalus, infarcts, tuberculomas, abscesses, and cerebritis was analyzed in both cohorts. Results:  Hydrocephalus was significantly more frequent in TBM (46.9%) compared to ABM (23%, p < 0.001). Tuberculomas were exclusive to TBM (57.3%, p < 0.001), while abscesses (6.3%) and subdural collections (8.4%) were unique to ABM (p < 0.05). Infarcts occurred at similar rates in both groups (27% vs. 28.1%, p = 0.88). Logistic regression identified TBM as an independent predictor of hydrocephalus (OR: 3.4, 95% CI: 2.1–5.8,p < 0.001) and tuberculomas (OR: 18.7, 95% CI: 11.4–30.9, p < 0.001). These findings emphasize the distinct radiological complication patterns in ABM and TBM, aiding in tailored management strategies. Conclusion:  The use of regression analysis provided new insights into predictors of complications; while cerebral infarcts are common in both ABM and TBM, TBM showed a greater burden of complications, particularly hydrocephalus and tuberculomas. The findings highlight the importance of early diagnosis and tailored treatment strategies to reduce morbidity and mortality in both forms of meningitis.