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tuberculous meningitis

Yi-Yi Wang, Bing-di Xie
Central nervous system (CNS) disease caused by Mycobacterium tuberculosis (MTB) is highly devastating. Tuberculous meningitis (TBM) is the most common form of CNS tuberculosis (TB). Rapid, sensitive, and affordable diagnostic tests are not available. Ziehl-Neelsen (ZN) stain has a very low sensitivity in cases of TBM, the sensitivity rates is of about 10-20%.The detection rate can be improved by taking large volume CSF samples (>6 ml) and prolonged slide examination (30 min). Culture of MTB from the CSF is slow and insufficiently sensitive...
2018: Methods in Molecular Biology
Taty Tshimangani, Jean Pongo, Joseph Bodi Mabiala, Marcel Yotebieng, Nicole F O'Brien
Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions...
March 5, 2018: American Journal of Tropical Medicine and Hygiene
Angharad Davis, Graeme Meintjes, Robert J Wilkinson
PURPOSE OF REVIEW: Tuberculous meningitis (TBM) is a global health problem. In this review, we systematically evaluate the evidence for current and emerging antimicrobials, host-directed therapies and supportive managements. RECENT FINDINGS: Current antimicrobial regimes do not factor the differing ability of drugs to cross the blood-brain barrier. Rifampicin may be more effective at higher doses yet the most recent clinical trial failed to demonstrate survival benefit at 15 mg/kg/day...
February 28, 2018: Current Treatment Options in Neurology
Nguyen Th Mai, Nicholas Dobbs, Nguyen Hoan Phu, Romain A Colas, Le Tp Thao, Nguyen Tt Thuong, Ho Dt Nghia, Nguyen Hh Hanh, Nguyen T Hang, A Dorothee Heemskerk, Jeremy N Day, Lucy Ly, Do DA Thu, Laura Merson, Evelyne Kestelyn, Marcel Wolbers, Ronald Geskus, David Summers, Nguyen Vv Chau, Jesmond Dalli, Guy E Thwaites
Background Adjunctive dexamethasone reduces mortality from tuberculous meningitis (TBM) but not disability, which is associated with brain infarction. We hypothesised that aspirin prevents TBM-related brain infarction through its anti-thrombotic, anti-inflammatory, and pro-resolution properties. Methods We conducted a randomised controlled trial in HIV-uninfected adults with TBM of daily aspirin 81mg or 1000mg, or placebo, added to the first 60 days of anti-tuberculosis drugs and dexamethasone (NCT02237365)...
February 27, 2018: ELife
Li-Kai Huang, Chien-Min Lin, Chi-Jen Chen, Chaur-Jong Hu
No abstract text is available yet for this article.
September 15, 2017: Acta Neurologica Taiwanica
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
Lely Solari, Alonso Soto, Patrick van der Stuyft
OBJECTIVES: Diagnosis of Tuberculous Meningitis (TM) is a challenge in countries with a high burden of the disease and constrained resources and Clinical Prediction Rules (CPRs) could be of assistance. We aimed at developing a CPR for diagnosis of TM in a Latin American setting with high tuberculosis incidence and a concentrated HIV epidemic. METHODS: We enrolled adult patients with clinical suspicion of TM attending two hospitals in Lima, Peru. We obtained information on potential anamnestic, clinical and laboratory predictive findings that are easy to collect and promptly available...
February 15, 2018: Tropical Medicine & International Health: TM & IH
Lidya Chaidir, Jessi Annisa, Sofiati Dian, Ida Parwati, Arlisa Alisjahbana, Feby Purnama, Adri van der Zanden, Ahmad Rizal Ganiem, Reinout van Crevel
We evaluated microbiological diagnosis of tuberculous (TB) meningitis in a referral hospital in Indonesia. Over a ten-year period, we examined cerebrospinal fluid (CSF) samples of 1180 adult meningitis suspects. Sensitivity of different methods was compared, and results were stratified for HIV status, disease severity, and CSF volume. TB meningitis was bacteriologically confirmed in 501 patients. Using clinical diagnosis as reference standard (n = 713), sensitivity of different methods was 12.2% (86/703) for microscopy, 42% (73/174) for Xpert MTB/RIF, 46...
January 9, 2018: Diagnostic Microbiology and Infectious Disease
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
Sarah J Dunstan, Maxine Caws
No abstract text is available yet for this article.
February 1, 2018: Lancet Infectious Diseases
Svas Raju Kakarlapudi, Anila Chacko, Prasanna Samuel, Valsan Philip Verghese, Winsley Rose
OBJECTIVE: To compare scrub typhus meningitis with bacterial and tuberculous meningitis. METHODS: Children aged <15 years admitted with meningitis were screened and those who fit criteria for diagnosis of scrub typhus meningitis (n=48), bacterial meningitis (n=44) and tuberculous meningitis (n=31) were included for analysis. Clinical features, investigations and outcomes were compared between the three types of meningitis. RESULTS: Mean age, duration of fever at presentation, presence of headache and, altered sensorium and presence of hepatomegaly/splenomegaly were statistically significantly different between the groups...
January 15, 2018: Indian Pediatrics
Stalin Viswanathan
No abstract text is available yet for this article.
January 15, 2018: Indian Pediatrics
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
Ikanyeng D Seipone, Ravesh Singh, Vinod B Patel, Avashna Singh, Michelle L Gordon, Daniel M Muema, Keertan Dheda, Thumbi Ndung'u
To gain a better understanding of the immunopathogenesis of tuberculous meningitis (TBM) and identify potential diagnostic biomarkers that may discriminate TBM from other HIV-1-associated meningitides, we assessed HIV-1 viral load levels, drug resistance patterns in antiretroviral therapy (ART)-experienced patients with persistent viremia and soluble immunological analytes in peripheral blood and cerebrospinal fluid (CSF) of HIV-1 infected patients with TBM versus other meningitides. One hundred and three matched blood and CSF samples collected from HIV-1 infected patients with TBM or other meningitides presenting at a hospital in Durban, South Africa, from January 2009 to December 2011 were studied...
2018: PloS One
Hyunjo Lee, Taewon Kim
No abstract text is available yet for this article.
November 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Jian Liang Tan, Sudzilla Nordin, Alwi Muhd Besari
Introduction: Tuberculosis is the second leading cause of death under the category of infectious diseases, after the human immunodeficiency virus (HIV). Tuberculous meningitis (TBM) constitutes about 5% of all extrapulmonary disease worldwide. This report describes a case of Tuberculous meningitis with rare presentation in a 28-year-old woman, who was treated based on a collection of her social background, clinical findings and Multiplex PCR of tuberculosis. Case presentation: A 28-year-old Malay woman with no significant medical history presented to HUSM with one month history of on and off fever, two weeks history of generalised limbs weakness and one week history of dysphagia...
October 2017: Malaysian Journal of Medical Sciences: MJMS
Naveed Anjum, Nuzhat Noureen, Imran Iqbal
OBJECTIVE: To determine the clinical presentations and outcomes of the children suffering from tuberculous meningitis. METHODS: This prospective, descriptive study was conducted at the Children's Hospital and the Institute of Child Health, Multan, Pakistan, from February to December 2015. The Pakistan Paediatric Association scoring chart for tuberculosis was used as a tool for the probable diagnosis. The clinical symptoms with their durations were noted. Clinical stages of tuberculous meningitis, cerebrospinal fluid analysis and computerised tomography brain findings were noted for each patient...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Zhan Chen, Xiao-Yi Shao, Chao Wang, Min-Hui Hua, Cheng-Niu Wang, Xin Wang, Qian-Jin Wang, Jin-Yi Yao, Yi-Hui Fan, Yong-Wei Qin
Mycobacterium tuberculosis (M. tuberculosis) invading and activating microglia causes the most serious subtypes of tuberculosis called tubercular meningitis. However, the developmental process of tubercular meningitis, especially the early phase, is poorly understood due to lacking well-established and well-accepted visible models in vitro and in vivo. Here, consistent with one recent report, we found Mycobacterium marinum (M. marinum) invade the zebrafish brain and subsequently cause granuloma-like structures...
January 20, 2018: Journal of Molecular Neuroscience: MN
(no author information available yet)
No abstract text is available yet for this article.
January 17, 2018: BMJ Case Reports
Suzaan Marais, Izanne Roos, Ayesha Mitha, Sepelong J Mabusha, Vinod Patel, Ahmed I Bhigjee
Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations. Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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