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https://www.readbyqxmd.com/read/28427368/complications-of-miliary-tuberculosis-low-mortality-and-predictive-biomarkers-from-a-uk-cohort
#1
Jonathan Underwood, Fiona Cresswell, Alex P Salam, Alex J Keeley, Charles Cleland, Laurence John, Robert N Davidson
BACKGROUND: Untreated, miliary tuberculosis (TB) has a mortality approaching 100%. As it is uncommon there is little specific data to guide its management. We report detailed data from a UK cohort of patients with miliary tuberculosis and the associations and predictive ability of admission blood tests with clinical outcomes. METHODS: Routinely collected demographic, clinical, blood, imaging, histopathological and microbiological data were assessed for all patients with miliary TB identified from the London TB register from 2008 to 2012 from Northwest London Hospitals NHS Trust...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28410692/treatment-outcome-of-extrapulmonary-tuberculosis-under-revised-national-tuberculosis-control-programme
#2
J J Cherian, I Lobo, A Sukhlecha, U Chawan, N A Kshirsagar, B L Nair, L Sawardekar
BACKGROUND: Extrapulmonary tuberculosis (EPTB) constitutes 15-20% of tuberculosis cases in India. Earlier studies have evaluated treatment outcomes of EPTB with little information on outcomes of individual site of EPTB. AIMS: The objective was to study the outcome of Directly Observed Treatment Short course (DOTS) treatment of EPTB in different organ systems under Revised National Tuberculosis Control Programme. METHODS: Multi-centric retrospectives record review was carried out in three states in India...
April 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28404679/evaluation-of-taqman-array-card-tac-for-the-detection-of-central-nervous-system-infections-in-kenya
#3
Clayton O Onyango, Vladimir Loparev, Shirley Lidechi, Vinod Bhullar, D Scott Schmid, Kay Radford, Michael K Lo, Paul Rota, Barbara W Johnson, Jorge Munoz, Martina Oneko, Deron Burton, Carolyn M Black, John Neatherlin, Joel M Montgomery, Barry Fields
Infections of the central nervous system (CNS) are often acute with significant morbidity and mortality. Routine diagnosis of such infections is limited in developing countries and requires modern equipment in advanced laboratories that may be unavailable to a number of patients in sub-Saharan Africa. We developed a TaqMan Array Card (TAC) that detects multiple pathogens simultaneously from cerebrospinal fluid (CSF). The 21-pathogen TAC assays include two parasites (Balamuthia mandrillaris and Acanthamoeba), six bacterial pathogens (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Mycoplasma pneumoniae, Mycobacterium tuberculosis, and Bartonella) and 13 viruses (parechovirus, dengue, nipah, varicella zoster, mumps, measles, lyssa, herpes simplex virus 1 and 2, Epstein Barr virus, enterovirus, cytomegalovirus and chikungunya)...
April 12, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28397100/the-burden-and-epidemiology-of-community-acquired-central-nervous-system-infections-a-multinational-study
#4
H Erdem, A Inan, E Guven, S Hargreaves, L Larsen, G Shehata, E Pernicova, E Khan, L Bastakova, S Namani, A Harxhi, T Roganovic, B Lakatos, S Uysal, O R Sipahi, A Crisan, E Miftode, R Stebel, B Jegorovic, Z Fehér, C Jekkel, N Pandak, A Moravveji, H Yilmaz, A Khalifa, U Musabak, S Yilmaz, A Jouhar, N Oztoprak, X Argemi, M Baldeyrou, G Bellaud, R V Moroti, R Hasbun, L Salazar, R Tekin, A Canestri, L Čalkić, L Praticò, F Yilmaz-Karadag, L Santos, A Pinto, F Kaptan, P Bossi, J Aron, A Duissenova, G Shopayeva, B Utaganov, S Grgic, G Ersoz, A K L Wu, K C Lung, A Bruzsa, L B Radic, H Kahraman, M Momen-Heravi, S Kulzhanova, F Rigo, M Konkayeva, Z Smagulova, T Tang, P Chan, S Ahmetagic, H Porobic-Jahic, F Moradi, S Kaya, Y Cag, A Bohr, C Artuk, I Celik, M Amsilli, H C Gul, A Cascio, M Lanzafame, M Nassar
Risk assessment of central nervous system (CNS) infection patients is of key importance in predicting likely pathogens. However, data are lacking on the epidemiology globally. We performed a multicenter study to understand the burden of community-acquired CNS (CA-CNS) infections between 2012 and 2014. A total of 2583 patients with CA-CNS infections were included from 37 referral centers in 20 countries. Of these, 477 (18.5%) patients survived with sequelae and 227 (8.8%) died, and 1879 (72.7%) patients were discharged with complete cure...
April 10, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28283299/central-nervous-system-tuberculosis-an-imaging-perspective
#5
REVIEW
Vikas Chaudhary, Shahina Bano, Umesh Chandra Garga
The increasing prevalence of tuberculosis in both immunocompetent and immunocompromised individuals in recent years makes the disease a topic of universal concern. It has insidious onset and can affect virtually any organ system in the body, including the central nervous system (CNS). CNS tuberculosis (TB) is becoming more and more complex and atypical with onset of multidrug-resistant TB. Routine diagnostic techniques using serology and body tissue are time consuming and may delay the definitive management...
March 7, 2017: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/28281443/central-nervous-system-tuberculosis
#6
John M Leonard
Central nervous system tuberculosis (CNS-TB) takes three clinical forms: meningitis (TBM), intracranial tuberculoma, and spinal arachnoiditis. TBM predominates in the western world and presents as a subacute to chronic meningitis syndrome with a prodrome of malaise, fever, and headache progressing to altered mentation and focal neurologic signs, followed by stupor, coma, and death within five to eight weeks of onset. The CSF formula typically shows a lymphocytic pleocytosis, and low glucose and high protein concentrations...
March 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28280495/myeloid-and-t-cell-derived-tnf-protects-against-central-nervous-system-tuberculosis
#7
Nai-Jen Hsu, Ngiambudulu M Francisco, Roanne Keeton, Nasiema Allie, Valérie F J Quesniaux, Bernhard Ryffel, Muazzam Jacobs
Tuberculosis of the central nervous system (CNS-TB) is a devastating complication of tuberculosis, and tumor necrosis factor (TNF) is crucial for innate immunity and controlling the infection. TNF is produced by many cell types upon activation, in particularly the myeloid and T cells during neuroinflammation. Here we used mice with TNF ablation targeted to myeloid and T cell (MT-TNF(-/-)) to assess the contribution of myeloid and T cell-derived TNF in immune responses during CNS-TB. These mice exhibited impaired innate immunity and high susceptibility to cerebral Mycobacterium tuberculosis infection, a similar phenotype to complete TNF-deficient mice...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28253602/-a-clinical-report-of-five-cases-of-central-nervous-system-miliary-tuberculomas-first-diagnosed-by-neurologists
#8
X Huang, X Y Wang, Z H Zhu, X K Qi, Y X Yu
To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system(CNS). A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study. All clinical and imaging data were collected and analyzed retrospectively. The main initial symptoms were fever and headache (4/5). Multiple diffused miliary lesions were shown by brain MRI, with maximum diameter ranged from 1-4 mm and ring-shape or nodular enhancement after gadolinium injection...
March 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28173836/complex-regulation-of-neutrophil-derived-mmp-9-secretion-in-central-nervous-system-tuberculosis
#9
Catherine W M Ong, Przemyslaw J Pabisiak, Sara Brilha, Poonam Singh, Federico Roncaroli, Paul T Elkington, Jon S Friedland
BACKGROUND: Central nervous system tuberculosis (CNS-TB) may be fatal even with treatment. Neutrophils are the key mediators of TB immunopathology, and raised CSF matrix metalloproteinase-9 (MMP-9) which correlates to neutrophil count in CNS-TB is associated with neurological deficit and death. The mechanisms by which neutrophils drive TB-associated CNS matrix destruction are not clearly defined. METHODS: Human brain biopsies with histologically proven CNS-TB were stained for neutrophils, neutrophil elastase, and MMP-9...
February 7, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28104935/neurotuberculosis-immune-reconstitution-inflammatory-syndrome-in-the-setting-of-hiv-infection-a-case-report-and-review-of-literature
#10
Deepasree Jaganmohan, Sunitha V Chakkalakkoombil, Anjana A Beena, Nagarajan Krishnan
Immune reconstitution inflammatory syndrome (IRIS) is an exaggerated immune response which can occur with various coinfections in human immunodeficiency virus (HIV) infected patients, of which the most commonly implicated in central nervous system (CNS)-IRIS are progressive multifocal leukoencephalopathy (PML), cryptococcosis, and tuberculosis (TB). TB-IRIS is a known complication of pulmonary TB or TB lymphadenitis coinfection in HIV infected patients who are on antituberculosis treatment (ATT) after the initiation of antiretroviral therapy (ART)...
October 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28092979/endovascular-treatment-of-hiv-associated-spontaneous-common-carotid-artery-pseudoaneurysm-in-a-case-of-miliary-and-cns-tuberculosis
#11
Rashmi Saraf, Amrita Narang, Mahesh Kardile, Prasad Udmale
HIV and tuberculosis infections are known to be associated with vasculopathy including occlusive disease and aneurysm formation. We report a case of 43-year-old male with miliary and central nervous system (CNS) tuberculosis; recently, diagnosed as HIV seropositive, on antiretroviral and antitubercular treatment presenting with painful neck swelling. He was found to have common carotid artery (CCA) pseudoaneurysm that was managed by endovascular stent grafting. HIV vasculopathy-related CCA pseudoaneurysm is a potentially life-threatening rare entity...
January 17, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28043538/murine-model-of-tb-meningitis
#12
Umesh Datta Gupta, Ali Abbas, Raj Pal Singh Kashyap, Pushpa Gupta
BACKGROUND: Central nervous system (CNS) infections caused by Mycobacterium tuberculosis (MTB) are the most severe forms of extrapulmonary TB (EPTB) due to high levels of mortality and neurological morbidity. Limited studies are available on CNS-TB animal-model development, despite the steady rise in cerebral-TB cases in India over the past decade. This 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...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28003499/new-onset-seizure-in-hiv-infected-adult-zambians-a-search-for-causes-and-consequences
#13
Omar K Siddiqi, Melissa A Elafros, Christopher M Bositis, Igor J Koralnik, William H Theodore, Jason F Okulicz, Lisa Kalungwana, Michael J Potchen, Izukanji Sikazwe, Gretchen L Birbeck
OBJECTIVE: To identify the etiology of new-onset seizure in HIV-infected Zambian adults and identify risk factors for seizure recurrence. METHODS: A prospective cohort study enrolling HIV-infected adults with new-onset seizure within 2 weeks of index seizure obtained clinical, laboratory, and neuroimaging data to determine seizure etiology. Participants were followed to identify risk factors for seizure recurrence. Risk factors for mortality were examined as mortality rates were unexpectedly high...
January 31, 2017: Neurology
https://www.readbyqxmd.com/read/27935825/microglia-activation-in-a-pediatric-rabbit-model-of-tuberculous-meningitis
#14
Elizabeth W Tucker, Supriya Pokkali, Zhi Zhang, Vincent P DeMarco, Mariah Klunk, Elizabeth S Smith, Alvaro A Ordonez, Marie-France Penet, Zaver Bhujwalla, Sanjay K Jain, Sujatha Kannan
Central nervous system (CNS) tuberculosis (TB) is the most severe form of extra-pulmonary TB and disproportionately affects young children where the developing brain has a unique host response. New Zealand white rabbits were infected with Mycobacterium tuberculosis via subarachnoid inoculation at postnatal day 4-8 and evaluated until 4-6 weeks post-infection. Control and infected rabbit kits were assessed for the development of neurological deficits, bacterial burden, and postmortem microbiologic and pathologic changes...
December 1, 2016: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/27833967/diagnosing-hiv-associated-cerebral-diseases-the-importance-of-neuropathology-in-understanding-hiv
#15
Ioan Alexandru Diaconu, LaurenŢiu MihăiŢă Stratan, Luciana Nichita, Victoria Aramă, Valentina Ruxandra Moroti Constantinescu, Alexandra Ioana Diaconu, Daniela Adriana Ion
The study aims to compare two aspects concerning the diagnosis of acquired immune deficiency syndrome (AIDS)-associated central nervous system (CNS) pathology (neuroAIDS): clinical diagnoses issued ante mortem with pathology results issued post mortem. The group of 39 human immunodeficiency virus (HIV)-positive patients was created over 23 years and is limited by marked heterogeneity. The enrolled cases were treated at the "Prof. Dr. Matei Bals" National Institute for Infectious Diseases, Bucharest, Romania, deceased due to AIDS-related complications and underwent brain necropsies performed in the Pathology Laboratory at the "Colentina" Clinical Hospital, Bucharest...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27794456/infections-of-the-central-nervous-system-after-unrelated-donor-umbilical-cord-blood-transplantation-or-human-leukocyte-antigen-matched-sibling-transplantation
#16
Aitana Balaguer Rosello, Luis Bataller, Ignacio Lorenzo, Isidro Jarque, Miguel Salavert, Eva González, José Luis Piñana, Teresa Sevilla, Pau Montesinos, Gloria Iacoboni, Nuria Muelas, Samuel Romero, Carlos Carretero, Juan Montoro, Maria Jose Ibáñez-Juliá, Guillermo Sanz, Miguel Ángel Sanz, Jaime Sanz
We analyzed the incidence, clinical characteristics, prognostic factors, and outcome of central nervous system (CNS) infections in consecutive patients with receiving umbilical cord blood transplantation (UCBT) (n = 343) or HLA-matched sibling donor stem cell transplantation (MST) (n = 366). Thirty-four CNS infections were documented at a median time of 116 days after transplantation (range, 7 to 1161). The cumulative incidence (CI) risk of developing a CNS infection was .6% at day +30, 2.3% at day +90, and 4...
January 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27688977/chromosomal-rearrangements-and-protein-globularity-changes-in-mycobacterium-tuberculosis-isolates-from-cerebrospinal-fluid
#17
Seow Hoon Saw, Joon Liang Tan, Xin Yue Chan, Kok Gan Chan, Yun Fong Ngeow
BACKGROUND: Meningitis is a major cause of mortality in tuberculosis (TB). It is not clear what factors promote central nervous system invasion and pathology but it has been reported that certain strains of Mycobacterium tuberculosis (Mtb) might have genetic traits associated with neurotropism. METHODS: In this study, we generated whole genome sequences of eight clinical strains of Mtb that were isolated from the cerebrospinal fluid (CSF) of patients presenting with tuberculous meningitis (TBM) in Malaysia, and compared them to the genomes of H37Rv and other respiratory Mtb genomes either downloaded from public databases or extracted from local sputum isolates...
2016: PeerJ
https://www.readbyqxmd.com/read/27638822/-extrathoracic-manifestations-of-tuberculosis
#18
D Kienzl-Palma, H Prosch
CLINICAL/METHODICAL ISSUE: Besides the lungs, tuberculosis (TB) can affect any organ system. In most cases, extrathoracic TB occurs in immunosuppressed patients as part of a severe illness via hematogenous spread. Extrathoracic involvement most commonly involves abdominal organs, especially the urogenital tract and less commonly the central nervous system (CNS) and the musculoskeletal system. Most frequently, computed tomography (CT) is used for detecting extrathoracic TB manifestations, except for CNS and musculoskeletal manifestations, where contrast-enhanced magnetic resonance imaging (MRI) is the gold standard...
October 2016: Der Radiologe
https://www.readbyqxmd.com/read/27623022/tetrahydroisoquinolines-in-therapeutics-a-patent-review-2010-2015
#19
REVIEW
Inder Pal Singh, Purvi Shah
1,2,3,4-Tetrahydroisoquinoline (THIQ) is one of the 'privileged scaffolds', commonly found in nature. Initially, this class of compounds was known for its neurotoxicity. Later on, 1-methyl-1,2,3,4-tetrahydroisoquinoline was proved as an endogeneous Parkinsonism-preventing agent in mammals. The fused THIQs have been studied for their role as anticancer antibiotics. The US FDA approval of the trabectedin for the treatment of soft tissue sarcomas, is a milestone in the anticancer drug discovery. Areas covered: This review covers the patents on various therapeutic activities of the THIQ derivatives in the years between 2010 and 2015...
January 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/27583209/hemiballistic-movements-in-a-newly-hiv-patient
#20
Rita Magano, Rita Jorge, Margarida Prata, Maria Conceição Ventura, José Gabriel Saraiva da Cunha
Infections of central nervous system (CNS) include a broad group of conditions and pose a particular challenge to physicians, especially in immunocompromised individuals. This case refers to a 26-year-old male patient with a history of smoked hashish and drug abuse admitted to the infectious disease department with hemiballismus of left hemibody and a positive HIV serologic test. A magnetic resonance imaging (MRI) study showed lesions at lower left and right cerebellar hemisphere, one of them thalamus - mesencephalic suggesting an opportunistic infection or an HIV associated encephalopathy...
2016: IDCases
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