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tuberculous meningitis

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https://www.readbyqxmd.com/read/28605426/biomarkers-of-cerebral-injury-and-inflammation-in-pediatric-tuberculous-meningitis
#1
Ursula K Rohlwink, Katya Mauff, Katalin A Wilkinson, Nico Enslin, Emmanuel Wegoye, Robert J Wilkinson, Anthony A Figaji
Background: Tuberculous meningitis (TBM) leads to death or disability in half the affected individuals. Tools to assess severity and predict outcome are lacking. Neuro-specific biomarkers could serve as markers of the severity and evolution of brain injury, but have not been widely explored in TBM. We examined biomarkers of neurological injury (neuromarkers) and inflammation in pediatric TBM and their association with outcome. Methods: Blood and cerebrospinal fluid (CSF) of children with TBM and hydrocephalus taken on admission and over 3 weeks were analysed for neuromarkers S100B, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), and multiple inflammatory markers...
June 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28594104/the-risk-factor-of-false-negative-and-false-positive-for-t-spot-tb-in-active-tuberculosis
#2
Li Di, Yan Li
OBJECTIVES: T-SPOT.TB is a promising diagnosis tool to identify both pulmonary tuberculosis and extrapulmonary tuberculosis, as well as latent tuberculosis; however, the factors that affect the results of T-SPOT.TB remains unclear. In this study, we aim to figure out the risk factor of T-SPOT.TB for active TB. METHODS: A total of 349 patients were recruited between January 1st, 2016 and January 22st, 2017 at Renmin Hospital of Wuhan University, including 98 subjects with TB and 251 subjects with non-TB disease, and received T-SPOT...
June 8, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28589071/a-case-report-on-complicated-tuberculous-meningitis
#3
Nadia Jawad, Saira Jafri, Syeda Naqvi, Syed Masroor Ahmad, Shabnam Naveed, Zeeshan Ali
Tuberculous meningitis (TBM) is associated with significant complications of central nervous system. It is accompanied by nonspecific and heterogeneous clinical symptoms. We focused on the significance of early diagnosis and prompt treatment. We describe a case of TBM in a 19-year-old Asian female. She had a progressive motor weakness with no sensory findings. She was started on antituberculous therapy. Her magnetic resonance imaging (MRI) contrast of dorsolumbar spine showed syringomyelia. Her culture and sensitivity for Mycobacterium tuberculosis (MTB) came negative...
May 4, 2017: Curēus
https://www.readbyqxmd.com/read/28571185/determination-and-validation-of-a-lower-cut-off-value-of-cerebrospinal-fluid-adenosine-deaminase-csf-ada-activity-in-diagnosis-of-tuberculous-meningitis
#4
Raviraj, Renoy A Henry, G Ganapathi Rao
INTRODUCTION: Tuberculous meningitis is an infection of the meninges caused by Mycobacterium tuberculosis. It is one of the most common infectious diseases of the Central Nervous System (CNS) and a major health problem in developing countries like India. If there is delay in diagnosis and initiation of specific treatment, it causes significant morbidity and mortality. CSF-ADA 10 U/l is the standard cut off value that is used for differentiation between Tuberculous (TBM) and Non-Tuberculous Meningitis (non-TBM)...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28571129/comparative-diagnostic-utility-of-is6110-pcr-assay-in-csf-and-peripheral-blood-samples-of-tuberculous-meningitis-patients-a-pilot-study-from-central-india
#5
Sonali D Manke, Aliabbas A Husain, Hatim F Daginawala, Lokendra K Singh, Rajpal S Kashyap
INTRODUCTION: Tuberculous Meningitis (TBM) is the most severe form of Central Nervous System Tuberculosis (CNS-TB) and constitutes about 6% of all Extrapulmonary TB (EPTB) cases. Most guidelines for the diagnosis and management of TBM agree on the use of simple Cerebrospinal Fluid (CSF) analysis using molecular tools like Polymerase Chain Reaction (PCR). However, the sensitivity of PCR varies while using a CSF sample. In the present study, we have compared the diagnostic utility of PCR assay in both peripheral blood and CSF sample collected from TBM cases...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28544969/prior-treatment-with-non-anti-tb-antibiotics-and-the-duration-of-symptoms-have-no-effect-on-diagnostics-of-tuberculous-meningitis
#6
Marcin Paciorek, Andrzej Pihowicz, Dominik Bursa, Joanna Schöntaler Humięcka, Justyna D Kowalska, Mateusz Antosiewicz, Magda E Thompson, Agata Skrzat-Wojdacz, Agnieszka Bednarska, Andrzej Horban
PURPOSE: Our objective was to investigate whether diagnosis of tuberculous meningitis (TBM) with microbiological and molecular analysis was affected by prior empirical non anti tuberculosis antibiotics or by duration of symptoms before lumbar puncture. MATERIALS AND METHODS: We retrospectively evaluated medical records of patients with TBM confirmed by positive culture, nucleic acid amplification techniques (NAATs) or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) or by characteristic results of biochemical analysis of CSF combined with a typical clinical manifestation...
May 22, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28540320/delayed-diagnosis-of-tuberculous-meningitis-misdiagnosed-as-herpes-simplex-virus-1-encephalitis-with-the-filmarray-syndromic-polymerase-chain-reaction-panel
#7
Carlos A Gomez, Benjamin A Pinsky, Anne Liu, Niaz Banaei
The FilmArray meningitis/encephalitis (ME) panel is a novel syndromic, nucleic acid amplification test for diagnosis of acute meningitis and encephalitis. Emerging data on its performance are concerning for false-positive results. We present a case of tuberculous meningitis misdiagnosed as herpes simplex virus-1 encephalitis with the FilmArray ME panel. Strategies to mitigate erroneous results are discussed.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28512616/surgical-management-of-syringomyelia-associated-with-spinal-adhesive-arachnoiditis-a-late-complication-of-tuberculous-meningitis-a-case-report
#8
Jun Seok Lee, Geun Sung Song, Dong Wuk Son
Syringomyelia associated with tuberculous meningitis is an extremely rare condition. Only a few studies have reported clinical experience with syringomyelia as a late complication of tuberculous meningitis. Twenty-six years after a tuberculous meningitis episode, a 44-year-old man presented with progressively worsening spastic paresis of the lower limbs and impaired urinary function for 2 years. Radiological examination revealed syringomyelia extending from the level of C2 to T9 and arachnoiditis with atrophy of the spinal cord between C2 and T3...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28506503/extended-clinical-spectrum-of-anti-n-methyl-d-aspartate-receptor-encephalitis-in-children-a-case-series
#9
Ajay Goenka, Vivek Jain, Hiroki Nariai, Alfred Spiro, Mitchell Steinschneider
OBJECTIVE: There is a wide spectrum of clinical manifestations in children with anti-N-methyl-d-aspartate (NMDA) receptor antibody encephalitis from two different health care settings. METHODS: We describe our experience with 13 patients (median age, 7 years; range, 5 months to 19 years) presenting to tertiary referral centers in India and the United States. RESULTS: Initial manifestations were neurological (seizures or movement disorders) in eight patients, and psychiatric (e...
July 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28504108/tuberculous-meningitis-and-hydrocephalus-in-filippino-de-medici
#10
Raffaella Bianucci, Philippe Charlier, Antonio Perciaccante, Otto Appenzeller, Donatella Lippi
No abstract text is available yet for this article.
June 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28501491/diagnostic-usefulness-of-xpert-mtb-rif-assay-for-detection-of-tuberculous-meningitis-using-cerebrospinal-fluid
#11
Syed Beenish Rufai, Amit Singh, Jitendra Singh, Parveen Kumar, Manimuthu Mani Sankar, Sarman Singh
OBJECTIVE: Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis (TB) due to association of diseases with high rates of mortality and morbidity. Diagnosis continues to be a clinical challenge as microbiological confirmation is rare and time consuming resulting in delayed treatment. Xpert MTB/RIF assay is a rapid and simple test, which has been endorsed by World Health Organization as an initial diagnostic test for the diagnosis of TBM. However, evidence still lacks for its performance on cerebrospinal fluid (CSF) for the diagnosis of TBM especially from India...
May 10, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28499348/total-delay-in-treatment-among-tuberculous-meningitis-patients-in-china-a-retrospective-cohort-study
#12
Yu He, Chao Han, Kai-Feng Chang, Mao-Shui Wang, Tian-Ren Huang
BACKGROUND: Currently, there is limited data on the risk factors associated with treatment delay in tuberculous meningitis (TBM). This study aimed to assess the duration of delay in the treatment TBM and to investigate its determinants. METHODS: During the period from September 2009 to February 2016, a retrospective cohort study of consecutive TBM patients admitted to our hospital was conducted to determine the risk factors associated with treatment delay in TBM...
May 12, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28492211/raised-adenosine-deaminase-in-the-cerebrospinal-fluid-a-tool-for-the-diagnosis-of-tuberculous-meningitis-in-developing-countries
#13
Purti A Saini, Preeti R Chakrabarti, Dosi Shilpi, Gambhir Shankhini, Gupta Priyanka, Tignath Gargi
CONTEXT: The rapid diagnosis followed by the early treatment of tuberculous meningitis (TBM) is important in preventing fatal outcomes. The mainstay of diagnosis lies in cerebrospinal fluid (CSF) analysis, radiological investigations, and clinical findings. AIM: The present study was conducted to determine the efficacy, sensitivity, and specificity of raised adenosine deaminase (ADA) level in CSF to differentiate TBM from non-TBM cases as a rapid, cost-effective, and noninvasive test...
January 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28482418/-cerebrospinal-fluid-adenosine-deaminase-and-its-dynamic-changes-in-tuberculous-meningitis
#14
X L Li, L P Ma, H M Chen, L Q Zhang, X G Wu, M Q Gao
Objective: To explore the diagnostic value of cerebrospinal fluid (CSF) adenosine deaminase (ADA) level in tuberculous meningitis. Methods: We retrospectively analyzed 139 patients (73 males, 66 females) who visited Beijing Chest Hospital for suspected TBM from January 2010 to June 2015. Of them, 99 patients were diagnosed to have TBM, with 45 males and 54 females, and a mean age of (33±15) years. Forty patients were diagnosed as having Non-TBM, with 28 males and 12 females, and a mean age of (35±18) years...
May 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28479800/factors-determining-the-clinical-spectrum-course-and-response-to-treatment-and-complications-in-seronegative-patients-with-central-nervous-system-tuberculosis
#15
Sadanandavalli Retnaswami Chandra, Sikandar Advani, Ravi Kumar, Chandrajith Prasad, Anupama R Pai
INTRODUCTION: Tuberculous meningitis remains a major health issue in the community affecting young adults of both genders predominantly from rural background. In India, the disease continues to kill 2 people every 3 min or nearly 1000 daily, according to the Tuberculosis Control Society India. Tuberculosis (TB) of central nervous system (CNS) is the most devastating form of TB. As this disease is associated with very high prevalence in young adults and will ultimately contribute to great workforce loss, we decided to assess the factors deciding the disease and its course in our patients...
April 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28472255/clinical-outcomes-of-patients-with-drug-resistant-tuberculous-meningitis-treated-with-an-intensified-antituberculosis-regimen
#16
A Dorothee Heemskerk, Mai Thi Hoang Nguyen, Ha Thi Minh Dang, Chau Van Vinh Nguyen, Lan Huu Nguyen, Thu Dang Anh Do, Thuong Thuy Thuong Nguyen, Marcel Wolbers, Jeremy Day, Thao Thi Phuong Le, Bang Duc Nguyen, Maxine Caws, Guy E Thwaites
Background.: Drug-resistant tuberculous meningitis (TBM) is difficult to diagnose and treat. Mortality is high and optimal treatment is unknown. We compared clinical outcomes of drug-resistant and -susceptible TBM treated with either standard or intensified antituberculosis treatment. Methods.: We analyzed the influence of Mycobacterium tuberculosis drug resistance on the outcomes of patients with TBM enrolled into a randomized controlled trial comparing a standard, 9-month antituberculosis regimen (containing rifampicin 10 mg/kg/day) with an intensified regimen with higher-dose rifampicin (15 mg/kg/day) and levofloxacin (20 mg/kg/day) for the first 8 weeks...
May 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28463219/-possible-paradoxical-reaction-to-treatment-of-tubercular-meningitis-in-an-hiv-negative-patient
#17
Ana C Rey Deutsch, Luz M Curi Dasso, José Stringa, Sebastián Grinspon, Mariano Volpachio, Octavio Mazzocchi
The paradoxical response to tuberculosis treatment consists in the appearance of new clinical or radiologic manifestations or worsening of previous injuries after an initial improvement with anti-tuberculosis therapy. It can be observed in 6 to 30 percent of the cases of tubercular meningitis. It is the consequence of an exaggerated immune reaction that should be considered since the treatment is based on the use of immunomodulators and not in the change of anti-tuberculous drugs. We present the case of an HIV negative adult with tuberculous meningitis with a good initial response to specific therapy who showed, 10 weeks later, a paradoxical reaction to treatment that responded successfully to corticosteroids...
2017: Medicina
https://www.readbyqxmd.com/read/28440255/clinical-profile-and-neuroimaging-in-pediatric-optic-neuritis-in-indian-population-a-case-series
#18
Rutika Khadse, Meenakshi Ravindran, Neelam Pawar, Padmavathy Maharajan, Ramakrishnan Rengappa
PURPOSE OF THE STUDY: The purpose of this study was to report clinical features, neuroimaging, and visual outcome in pediatric optic neuritis (ON) in Indian population. MATERIALS AND METHODS: This is a retrospective study of children up to the age of 16 years, diagnosed with ON, that presented at pediatric and neuroophthalmology clinic of a tertiary eye care center, in South India, within the period of 2010-2015. RESULTS: We identified 62 eyes of 40 children diagnosed as ON within the study period...
March 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28428929/treatment-of-posttubercular-syringomyelia-not-responsive-to-antitubercular-therapy-case-report-and-review-of-literature
#19
Giuseppe Canova, Alessandro Boaro, Enrico Giordan, Pierluigi Longatti
Posttubercular adhesive arachnoiditis is a rare, late complication of tubercular meningitis. Syringomyelia can develop as a consequence of intramedullary cystic lesions and cerebrospinal fluid (CSF) flow disturbance around the spinal cord, even after successful chemotherapy. We reviewed the literature related to posttubercular syringomyelia treatment and suggest a new combined surgical approach. A 25-year-old Nigerian male patient presented with legs numbness, urinary disturbance, and legs weakness. Spinal magnetic resonance revealed a T5-T7 syringomyelia, secondary to adhesive spinal arachnoiditis related to a history of tuberculous meningitis...
April 2017: Journal of Neurological Surgery Reports
https://www.readbyqxmd.com/read/28427163/the-application-of-is6110-baced-loop-mediated-isothermal-amplification-lamp-in-the-early-diagnosis-of-tuberculous-meningitis
#20
Wen-Wen Sun, Qin Sun, Li-Ping Yan, Qing Zhang
Here, we evaluated the potential activity of rapid Mycobacterium tuberculosis detection with loop-mediated isothermal amplification (LAMP), for the early diagnosis of tuberculous meningitis (TBM). Patients with suspected TBM from January 2014 to December 2015 were reviewed retrospectively. The cerebrospinalfluid(CSF) was collected. Acid-fast bacillus (AFB) staining, MGIT 960 culture, real-time fluorescent quantitative polymerase chain reaction (RTFQ PCR) and LAMP were performed. A total of 200 patients were included in the study...
February 25, 2017: Oncotarget
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