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CNS tuberculosis

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
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
Inder Pal Singh, Purvi Shah
INTRODUCTION: 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...
September 13, 2016: Expert Opinion on Therapeutic Patents
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
Praveen Kumar Srikanteswara, Praveen Kumar Pampapati, Kalpana Ramesh Yelsangikar
INTRODUCTION: Case reports pertaining to Magnetic Resonance Imaging (MRI) diagnosis of en-plaque tuberculoma are limited. To the best of our knowledge, descriptions about en-plaque tuberculoma are limited to few isolated case reports. This paper comprehensively depicts the clinical and radiological features in such patients and may serve not to miss this uncommon manifestation of a common central nervous system infection. MATERIALS AND METHODS: A descriptive documentation of the patient cohort with a detailed history and neurological examination were carried out in all the patients...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Burcu Zeydan, Ugur Uygunoglu, Sabahattin Saip, Onat N Demirci, Emire Seyahi, Serdal Ugurlu, Vedat Hamuryudan, Aksel Siva, Orhun H Kantarci
OBJECTIVE: We evaluated the effectiveness of infliximab in patients with neuro-Behçet syndrome for whom other immunosuppressive medications had failed. METHODS: Patients whose common immunosuppressive medications fail in recurrent neuro-Behçet syndrome need an alternative. We report our experience with the tumor necrosis factor α blocker infliximab for long-term treatment of neuro-Behçet syndrome. We recruited patients within a multidisciplinary referral practice of Behçet disease and prospectively followed everyone with a neurologic symptom(s)...
October 2016: Neurology® Neuroimmunology & Neuroinflammation
Eliza Manea, Daniela Munteanu, Raluca Jipa, Ruxandra Moroti, Victoria Arama, Ioan-Alexandru Diaconu, Adriana Hristea
BACKGROUND: Immune reconstitution inflammatory syndrome (IRIS) related to tuberculosis (TB) is an exacerbation of an inflammatory response that most often occurs in HIV-infected patients but it has also been observed in non-HIV immunocompromised hosts. We describe two cases of TB associated IRIS with CNS involvement, one in a patient diagnosed with HIV infection and the other in a patient with immunosuppression due to anti tumor necrosis factor treatment. CASE REPORT; The first case was a 40-year-old man, newly diagnosed with HIV infection, who developed right hemiplegia and expressive aphasia...
October 2015: Pneumologia: Revista Societății Române de Pneumologie
Heng Gee Lee, Timothy William, Jayaram Menon, Anna P Ralph, Eng Eong Ooi, Yan'an Hou, October Sessions, Tsin Wen Yeo
BACKGROUND: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections...
2016: BMC Infectious Diseases
Kamini Gupta, Avik Banerjee, Kavita Saggar, Archana Ahluwalia, Karan Saggar
BACKGROUND: Infections of the central nervous system (CNS) are common and routinely encountered. Our aim was to evaluate the neuroimaging features of the various infections of the CNS so as to differentiate them from tumoral, vascular, and other entities that warrant a different line of therapy. AIMS: Our aim was to analyze the biochemical and magnetic resonance imaging (MRI) features in CNS infections. SETTINGS AND DESIGN: This was a longitudinal, prospective study over a period of 1½ years...
January 2016: Journal of Pediatric Neurosciences
Anuj K Rathi, Riyaz Syed, Han-Seung Shin, Rahul V Patel
INTRODUCTION: Piperazine, a six membered nitrogen containing heterocycle, is of great significance to the rational design of drugs. This moiety can be found in a plethora of well-known drugs with various therapeutic uses, such as antipsychotic, antihistamine, antianginal, antidepressant, anticancer, antiviral, cardio protectors, anti-inflammatory, and imaging agents. Slight modification to the substitution pattern on the piperazine nucleus facilitates a recognizable difference in the medicinal potential of the resultant molecules...
July 2016: Expert Opinion on Therapeutic Patents
William R Folk, Aaron Smith, Hailong Song, Dennis Chuang, Jianlin Cheng, Zezong Gu, Grace Sun
Millions of individuals with active TB do not receive recommended treatments, and instead may use botanicals, or use botanicals concurrently with established treatments. Many botanicals protect against oxidative stress, but this can interfere with redox-dependent activation of isoniazid and other prodrugs used for prophylaxis and treatment of TB, as suggested by results of a recent clinical trial of the South African botanical Sutherlandia frutescens (L.) R. Br. (Sutherlandia). Here we provide a brief summary of Sutherlandia's effects upon rodent microglia and neurons relevant to tuberculosis of the central nervous system (CNS-TB)...
September 2016: Neuromolecular Medicine
Juan-Fang Liu, Yuan Li, Kai Li, Xiao Zhang, Yi-Ning Yang, Gang Zhao, Zhi-Rong Liu
Neuro-Sweet disease (NSD) is Sweet disease with central nervous system (CNS) involvement. To the best of our knowledge, the present case report is the first to describe NSD complicated by endogenous infection with Mycobacterium tuberculosis. The present case report describes a male patient who developed NSD-induced meningitis, which initially manifested as a fever, headache and neck stiffness. Painful erythematous plaques subsequently developed on his face, neck and upper trunk. Brain magnetic resonance imaging was performed and the results were normal, whereas modified acid-fast stain analysis of the cerebrospinal fluid (CSF) provided a positive result...
April 2016: Experimental and Therapeutic Medicine
Sirawat Srichatrapimuk, Duangkamon Wattanatranon, Somnuek Sungkanuparph
Tuberculosis (TB) is a serious infectious disease that spreads globally. The ocular manifestations of TB are uncommon and diverse. TB panophthalmitis has been rarely reported. Here, we described a 38-year-old Thai man presenting with panophthalmitis of the right eye. Further investigation showed that he had concurrent TB lymphadenitis and central nervous system (CNS) tuberculoma, as well as HIV infection, with a CD4 cell count of 153 cells/mm(3). Despite the initial response to antituberculous agents, the disease had subsequently progressed and enucleation was required...
2016: Case Reports in Infectious Diseases
Saeed Arif, Khushbakht Ghazanfar, Waseem Wali Muhammad, Hamza Malik
Cryptococcal meningitis (CM) is life threatening fungal infection of central nervous system (CNS). Although it is commonly associated with immunosuppression but rarely it can occur in immune competent patient. We report a case of 21 year old non HIV infected girl. Based on initial diagnoses of tuberculosis Bacillus meningitis (TBM), she was started on anti-tuberculosis treatment (ATT). However failure to respond to treatment prompted a quest for alternative diagnosis. A final Diagnosis of CM was confirmed on latex agglutination antigen detection on cerebrospinal fluid (CSF) analysis...
October 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Marcilene Gomes Evangelista, Sandra Bertelli Ribeiro De Castro, Caio César De Souza Alves, Alyria Teixeira Dias, Viano Wyallison De Souza, Lívia Bittencourt Dos Reis, Luan Cristian Da Silva, Maria Christina Marques Nogueira Castañon, Rogério Estevam Farias, Maria Aparecida Juliano, Ana Paula Ferreira
Experimental autoimmune encephalomyelitis (EAE) is a model for the study of multiple sclerosis, which is an inflammatory and demyelinating disease of the central nervous system (CNS). Despite increased efforts to elucidate the function of toll-like receptors (TLRs) in autoimmune diseases of the CNS, the relative contribution of other factors, including the immunomodulatory properties of TLR signaling, role of the innate response and the presence or absence of myelin peptides remain unclear. The aim was to evaluate TLR expression in the CNS during EAE development by investigating the expression of TLRs in the initial phase of EAE and establishing correlations with the modulation of inflammatory factors...
June 2016: Autoimmunity
Linfu Zhou, Rui Wu, Xiaodan Shi, Dongyun Feng, Guodong Feng, Yining Yang, Wen Dai, Ting Bian, Tingting Liu, Ying He, Ming Shi, Gang Zhao
Early diagnosis and treatment are crucial for the outcome of central nervous system (CNS) infections. In this study, we developed a multiplex PCR-Luminex assay for the simultaneous detection of five major pathogens, including Mycobacterium tuberculosis, Cryptococcus neoformans, Streptococcus pneumoniae, and herpes simplex virus types 1 and 2, which frequently cause CNS infections. Through the hybridization reaction between multiplex PCR-amplified targets and oligonucleotide "anti-TAG" sequences, we found that the PCR-Luminex assay could detect as low as 10¹-10² copies of synthetic pathogen DNAs...
February 2016: International Journal of Environmental Research and Public Health
Hai Zou, Ke-Hua Pan, Hong-Ying Pan, Dong-Sheng Huang, Ming-Hua Zheng
Tuberculosis (TB) is a common disease to threaten human health. TB of the central nervous system (CNS) is rare but the most serious type of systemic TB because of its high mortality rate, serious neurological complications and sequelae. In this case report, we describe a woman who presented with walking instability, intracerebral hemorrhage and leptomeningeal enhancement due to tuberculosis meningitis. The patient had no significant medical history and the initial clinical symptoms were walking instability...
December 29, 2015: Oncotarget
Ashish Aggarwal, Devi Prasad Patra, Kirti Gupta, Harsimrat Bir Sodhi
BACKGROUND: Tuberculosis has long been a major health concern in developing countries and now has troubled developed world as well, owing to increase in patients with human immunodeficiency virus and immigration. Central nervous system tuberculosis accounts for approximately 1% of cases of tuberculosis. The pathologic presentation is varied, with intraparenchymal tuberculomas and pachymeningitis being the most common. Being a great mimicker, it simulates numerous diseases radiologically, and this is best realized when atypical forms are encountered...
April 2016: World Neurosurgery
Xi Chen, Kaori Sakamoto, Frederick D Quinn, Huanchun Chen, Zhenfang Fu
Invasion and traversal of the blood-brain barrier (BBB) by Mycobacterium tuberculosis cause meningeal tuberculosis (TB) in the central nervous system (CNS). Meningeal TB is a serious, often fatal disease that disproportionately affects young children. The mechanisms involved in CNS invasion by M. tuberculosis bacilli are poorly understood. In this study, we microscopically examined endosomal trafficking and measured survival of M. tuberculosis and M. bovis Bacille Calmette-Guérin (BCG) bacilli in murine brain microvascular endothelial cells (BMECs)...
October 20, 2015: Oncotarget
Alexandra Duque-Silva, Katherine Robsky, Jennifer Flood, Pennan M Barry
OBJECTIVES: To describe the epidemiology and factors associated with pediatric central nervous system (CNS) tuberculosis (TB) in California from 1993 to 2011. METHODS: We analyzed California TB registry data for persons aged ≤18 years, comparing CNS TB cases versus non-CNS TB cases reported from 1993 to 2011. Factors associated with CNS TB and TB deaths were identified by using multivariate logistic regression. RESULTS: A total of 200 CNS TB cases were reported...
November 2015: Pediatrics
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