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https://www.readbyqxmd.com/read/29456899/facial-weakness-diplopia-and-fever-in-a-31-year-old-an-atypical-case-of-tuberculous-meningitis
#1
Ahmed H Qavi, Tasnim F Imran, Zachariah Hasan, Fariha Ilyas
Tuberculous meningitis (TBM) is an infection of the central nervous system (CNS) meninges that carries high morbidity and mortality. It is important to recognize, as patients may present with atypical symptoms. We describe the case of a 31-year-old man with a history of diabetes who presented with a sub-acute onset of right-sided facial weakness and right gaze difficulty with diplopia. History revealed low-grade fever, right-sided headache, fatigue and moderate weight loss for the past several weeks. The patient did not report neck stiffness, rigidity, fever, chills or cough...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29438557/is-drug-induced-hepatitis-related-to-the-severity-of-tuberculous-meningitis
#2
Mritunjai Kumar, Jayantee Kalita, Abhilasha Tripathi, Usha K Misra
Background: Drug-induced hepatitis (DIH) occurs more commonly in tuberculous meningitis (TBM) than non-CNS tuberculosis. We evaluate DIH in TBM and its relationship with disease severity and surrogate markers of stress. Methods: Sixty-seven patients with TBM were included prospectively. The diagnosis of DIH was based on five times elevation of alanine amino transferase (ALT) in asymptomatic and three times in symptomatic patients, serum bilirubin 1.5 mg/dL or more occurring after 3 days of antitubercular drugs without any other cause of liver dysfunction; and improvement in liver function upon drug withdrawal...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29395996/cerebral-tryptophan-metabolism-and-outcome-of-tuberculous-meningitis-an-observational-cohort-study
#3
Arjan van Laarhoven, Sofiati Dian, Raúl Aguirre-Gamboa, Julian Avila-Pacheco, Isis Ricaño-Ponce, Carolien Ruesen, Jessi Annisa, Valerie A C M Koeken, Lidya Chaidir, Yang Li, Tri Hanggono Achmad, Leo A B Joosten, Richard A Notebaart, Rovina Ruslami, Mihai G Netea, Marcel M Verbeek, Bachti Alisjahbana, Vinod Kumar, Clary B Clish, A Rizal Ganiem, Reinout van Crevel
BACKGROUND: Immunopathology contributes to the high mortality of tuberculous meningitis, but the biological pathways involved are mostly unknown. We aimed to compare cerebrospinal fluid (CSF) and serum metabolomes of patients with tuberculous meningitis with that of controls without tuberculous meningitis, and assess the link between metabolite concentrations and mortality. METHODS: In this observational cohort study at the Hasan Sadikin Hospital (Bandung, Indonesia) we measured 425 metabolites using liquid chromatography-mass spectrometry in CSF and serum from 33 HIV-negative Indonesian patients with confirmed or probable tuberculous meningitis and 22 control participants with complete clinical data between March 12, 2009, and Oct 27, 2013...
January 23, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29395320/pattern-recognition-receptor-mrna-expression-and-cytokine-and-granzyme-levels-in-hiv-infected-individuals-with-neurotuberculosis
#4
Deepashri Rao, Ravi Vasanthapuram, P Satishchandra, Anita Desai
Neurotuberculosis is one of the commonest HIV-associated opportunistic infections (OI) of the CNS. Cross-talk between HIV, Mycobacterium tuberculosis and host immune responses may alter expression of pattern recognition receptors (PRRs), thereby affecting cytokine profiles and functional responses. We examined PRR mRNA expression and cytokine and granzyme levels in HIV infected individuals with neurotuberculosis and found significant downregulation of TLR9 and increased MDA5 expression compared to healthy subjects...
January 27, 2018: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/29347976/intracisternal-tuberculoma-a-refractory-type-of-tuberculoma-indicating-surgical-intervention
#5
Fanfan Chen, Lei Chen, Yongfu Cao, Yongjun Yi, Jingwen Zhuang, Wuhua Le, Wei Xie, Lanbo Tu, Peng Li, Yimin Fang, Ling Li, Yuqing Kou, Kaikai Fu, Hua He, Hongbin Ju
BACKGROUND: Central nervous system (CNS) tuberculoma is a rare disease with severe neurological deficits. This retrospective research is to review the data of patients diagnosed as CNS tuberculoma. Surgeries were performed in all patients. The clinical features especially the neurological image and the anatomical characters of the tuberculomas were concerned. METHODS: Totally 11 patients diagnosed as CNS tuberculoma were admitted in Guangzhou First People's Hospital (7cases) and Changzheng Hospital (4 cases) during 2006-2015...
January 18, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29296673/glutathione-responsive-selenosulfide-prodrugs-as-a-platform-strategy-for-potent-and-selective-mechanism-based-inhibition-of-protein-tyrosine-phosphatases
#6
Caroline Chandra Tjin, Kate D Otley, Tyler D Baguley, Pradeep Kurup, Jian Xu, Angus C Nairn, Paul J Lombroso, Jonathan A Ellman
Dysregulation of protein tyrosine phosphorylation has been implicated in a number of human diseases, including cancer, diabetes, and neurodegenerative diseases. As a result of their essential role in regulating protein tyrosine phosphorylation levels, protein tyrosine phosphatases (PTPs) have emerged as important yet challenging therapeutic targets. Here we report on the development and application of a glutathione-responsive motif to facilitate the efficient intracellular delivery of a novel class of selenosulfide phosphatase inhibitors for the selective active site directed inhibition of the targeted PTP by selenosulfide exchange with the active site cysteine...
December 27, 2017: ACS Central Science
https://www.readbyqxmd.com/read/29290197/primary-cns-lymphoma-vs-tumefactive-multiple-sclerosis-a-diagnostic-challenge
#7
Sameen Bin Naeem, Farheen Niazi, Atif Baig, Hina Sadiq, Mubbasher Sattar
Primary CNS (central nervous system) lymphoma is a rare condition with the incidence of less than 1% of all non-Hodgkin lymphomas (NHLs) and approximately 2% of all primary brain tumours. Diagnosis can be challenging and necessitates brain biopsy for definitive diagnosis. A 41-year male presented with history of impaired cognition, facial asymmetry, visual impairment and left sided body weakness. MRI brain demonstrated multiple enhancing lesions with one larger lesion in right basal ganglia with surrounding oedema and mass effect...
January 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29201438/pathomorphological-peculiarities-of-tuberculous-meningoencephalitis-associated-with-hiv-infection
#8
Volodymyr M Kozko, Andriy V Bondarenko, Anatoliy V Gavrylov, Olga S Shevchenko, Vitalii V Gargin
Background and aims: One of the most severe manifestation displays of tuberculosis (TB) generalization is meningitis/meningoencephalitis. The purpose of this work was to improve the diagnostic efficiency of TB central nervous system (CNS) affection in human immunodeficiency virus (HIV)-infected persons. Materials and methods: Meninges and cerebral tissues, taken from died patients, who were HIV-infected and dead from TB of CNS affection, were investigated histologically...
September 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/29196175/anti-tubercular-and-probiotic-properties-of-coagulase-negative-staphylococci-isolated-from-koozh-a-traditional-fermented-food-of-south-india
#9
Ameer Khusro, Chirom Aarti, Azger Dusthackeer, Paul Agastian
In the last few years, the demand for the tremendous therapeutic applications of indigenous probiotic bacteria from diversified fermented food products has surged. In view of this, the present study was documented to evaluate the anti-tubercular and probiotic properties of coagulase-negative staphylococci (CNS) indigenous to Koozh, a traditional fermented food product of South India. A total of 18 isolates were purified from Koozh, and tested for anti-tubercular activity against Mycobacterium tuberculosis H37Rv using luciferase reporter phage (LRP) assay...
November 28, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29167512/matrix-metalloproteinase-9-activity-and-a-downregulated-hedgehog-pathway-impair-blood-brain-barrier-function-in-an-in-vitro-model-of-cns-tuberculosis
#10
Sara Brilha, Catherine W M Ong, Babette Weksler, Nacho Romero, Pierre-Olivier Couraud, Jon S Friedland
Central nervous system tuberculosis (CNS TB) has a high mortality and morbidity associated with severe inflammation. The blood-brain barrier (BBB) protects the brain from inflammation but the mechanisms causing BBB damage in CNS TB are uncharacterized. We demonstrate that Mycobacterium tuberculosis (Mtb) causes breakdown of type IV collagen and decreases tight junction protein (TJP) expression in a co-culture model of the BBB. This increases permeability, surface expression of endothelial adhesion molecules and leukocyte transmigration...
November 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29150377/urgent-versus-post-stabilisation-antiretroviral-treatment-in-hospitalised-hiv-infected-children-in-kenya-push-a-randomised-controlled-trial
#11
Irene N Njuguna, Lisa M Cranmer, Vincent O Otieno, Cyrus Mugo, Hellen M Okinyi, Sarah Benki-Nugent, Barbra Richardson, Joshua Stern, Elizabeth Maleche-Obimbo, Dalton C Wamalwa, Grace C John-Stewart
BACKGROUND: Urgent antiretroviral therapy (ART) among hospitalised HIV-infected children might accelerate recovery or worsen outcomes associated with immune reconstitution. We aimed to compare urgent versus post-stabilisation ART among hospitalised HIV-infected children in Kenya. METHODS: In this unmasked randomised controlled trial, we randomly assigned (1:1) HIV-infected, ART-naive children aged 0-12 years who were eligible for treatment to receive ART within 48 h (urgent group) or in 7-14 days (post-stabilisation group) at four hospitals in Kenya (two in Nairobi and two in western Kenya)...
January 2018: Lancet HIV
https://www.readbyqxmd.com/read/29067986/modelling-of-cerebral-tuberculosis-in-balb-c-mice-using-clinical-strain-from-patients-with-cns-tuberculosis-infection
#12
Aliabbas A Husain, Umesh Datta Gupta, Pushpa Gupta, Amit R Nayak, Nitin H Chandak, Hatim F Daginawla, Lokendra Singh, Rajpal Singh Kashyap
BACKGROUND & OBJECTIVES: Central nervous system (CNS) infection caused by Mycobacterium tuberculosis (MTB) is the most severe form of extrapulmonary tuberculosis (EPTB) due to a high level of mortality and morbidity. Limited studies are available on CNS-TB animal model development. The present study describes the development of a murine model of CNS-TB using a clinical strain (C3) isolated from the cerebrospinal fluid (CSF) of CNS-TB patients. METHODS: Groups of mice were infected by the intravenous route with MTB C3 strain isolated from the CSF of CNS-TB patients...
June 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29026544/central-nervous-system-tuberculosis-in-a-man-from-cambodia-with-worsening-headaches
#13
Daniel S Krauth, Kristi K Stone-Garza, Deirdre E Amaro, Sharon L Reed, Theodoros F Katsivas
Central nervous system (CNS) tuberculosis should be considered in patients from endemic nations with worsening neurological symptoms. If imaging reveals possible CNS tuberculomas, potentially life-threatening lesions should be excised and analyzed. When disease is less severe, other tissues possibly infected should be biopsied first for diagnosis to avoid neurosurgery.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28975470/infections-of-the-central-nervous-system-in-returning-travelers-and-immigrants
#14
REVIEW
Haley Thompson, Kiran Thakur
PURPOSE OF REVIEW: This review highlights current knowledge in travel-related neuroinfectious diseases, providing insight on approaches to prevention, diagnosis, and treatment of infections of the central nervous system (CNS) in travelers and immigrants. RECENT FINDINGS: Updates on travel vaccine recommendations including vaccine-specific interactions with immunosuppressive agents, advances in Zika virus and dengue virus vaccine development, new diagnostic criteria for neurocysticercosis, updates on treatment approaches for tuberculosis meningitis...
October 3, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28964954/a-rapid-and-simple-resazurin-assay-to-detect-minimum-inhibitory-concentration-for-first-line-drugs-of-mycobacterium-tuberculosis-isolated-from-cerebrospinal-fluid
#15
Kavitha Kumar, Prashant Giribhattanavar, Chandrasekhar Sagar, Shripad Patil
INTRODUCTION: Central nervous system tuberculosis (CNS-TB) is a devastating manifestation of TB. The most common form of CNS-TB is tuberculous meningitis (TBM). Drug-resistant TB poses a major threat to the control of TB worldwide. Timely treatment dramatically improves the outcome. Colorimetric techniques based on oxidation-reduction principle for drug susceptibility testing gives results quick and less expensive. OBJECTIVE: The objectives were to compare four first-line drugs' susceptibility of Mycobacterium tuberculosis isolated from cerebrospinal fluid by Mycobacteria growth indicator tube (MGIT) and resazurin assay (RA), also to estimate the minimum inhibitory concentration values by RA...
September 27, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28892927/a-rare-instance-of-levofloxacin-induced-myoclonus
#16
Sushil Kiran Kunder, A Avinash, Veena Nayak, Amod Tilak
Levofloxacin is a widely used fluoroquinolone, mainly as a respiratory antimicrobial agent. It is employed as a second line therapeutic modality in pulmonary tuberculosis as well. The drug has been in use for ages, and is known to be both efficacious and safe. However, it is not free of adverse effects. The most dangerous ones are those involving the Central Nervous System (CNS). Although rare, levofloxacin can cause involuntary movements like chorea and myoclonus. Here by, we present a case of an elderly male patient who developed reversible myoclonus/chorea after a course of levofloxacin (which was initiated as part of his anti-tubercular therapy) following the development of peripheral neuropathy secondary to isoniazid...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28866263/use-of-multiplex-pcr-based-molecular-diagnostics-in-diagnosis-of-suspected-cns-infections-in-tertiary-care-setting-a-retrospective-study
#17
Mahendra Javali, Purushottam Acharya, Aneesh Mehta, Aju Abraham John, Rohan Mahale, R Srinivasa
OBJECTIVES: CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28843822/clofazimine-protects-against-mycobacterium-tuberculosis-dissemination-in-the-cns-following-an-aerosol-challenge-in-a-murine-model
#18
Sooraj Baijnath, Chivonne Moodley, Bongani Ngcobo, Sanil D Singh, Hendrik G Kruger, Per I Arvidsson, Tricia Naicker, Alexander Pym, Thavendran Govender
BACKGROUND: Tuberculosis (TB) has been the scourge of the human race for many decades, claiming countless number of lives along the way. This is further complicated by the ability of Mycobacterium tuberculosis (M.tb) to infect extra-pulmonary sites, more specifically the brain. These forms of TB are difficult to treat due to the problems associated with drug delivery across the blood brain barrier (BBB). Linezolid (LZD and clofazimine (CFZ) are two of the more promising anti-TB antibiotics in recent times...
August 23, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28764615/cerebral-tuberculosis-in-a-patient-with-systemic-lupus-erythematosus-following-cyclophosphamide-treatment-a-case-report
#19
S Cooray, H Zhang, R Breen, G Carr-White, R Howard, M Cuadrado, D D'Cruz, G Sanna
Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28681808/genotypic-characterisation-of-mycobacterium-tuberculosis-isolates-from-tuberculous-meningitis-patients-at-a-tertiary-neurocare-centre-in-southern-india
#20
Akepati Chandramuki, Neelam Khanna, Elena Shashkina, Natalia Kurepina, Barun Mathema, Barry N Kreiswirth, Manjunatha M Venkataswamy
AIMS: Specific genotypes of Mycobacterium tuberculosis (MTB) have been reported to cause outbreaks of pulmonary tuberculosis (TB) in geographical areas that are endemic to TB. However, since there is little epidemiological evidence on the association of particular genotypes that cause tuberculous meningitis (TBM), we sought to investigate the association of specific MTB strains with infection of the central nervous system (CNS). MATERIALS AND METHODS: We carried out a genetic characterisation of 89 MTB isolates from TBM patients at a Southern Indian tertiary neurocare centre and compared the genotypes with strains of pulmonary TB isolated from Indian immigrants in New York City...
April 2017: Indian Journal of Medical Microbiology
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