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tuberculous meningitis

Louise Dunphy, Prashanth Shetty, Rabinder Randhawa, Kharil Amir Rani, Yaw Duodu
A 39-year-old man, born in India but resident in the UK for 10 years, was travelling in America when he became feverish with an altered mentation. He reported a 10-day history of fever, photophobia, headache and fatigue. His medical history included hypothyroidism and migraine. He was a non-smoker, did not consume alcohol and denied a history of drug use. He was transferred to the emergency department. Laboratory investigations confirmed hyponatraemia (sodium 128 mmol/L). A chest radiograph confirmed no focal consolidation...
October 7, 2016: BMJ Case Reports
Nguyen Duc Bang, Maxine Caws, Thai Thanh Truc, Tran Ngoc Duong, Nguyen Huy Dung, Dang Thi Minh Ha, Guy E Thwaites, Doortje Heemskerk, Joel Tarning, Laura Merson, Pham Van Toi, Jeremy J Farrar, Marcel Wolbers, Thomas Pouplin, Jeremy N Day
BACKGROUND: Tuberculous meningitis in adults is well characterized in Vietnam, but there are no data on the disease in children. We present a prospective descriptive study of Vietnamese children with TBM to define the presentation, course and characteristics associated with poor outcome. METHODS: A prospective descriptive study of 100 consecutively admitted children with TBM at Pham Ngoc Thach Hospital, Ho Chi Minh City. Cox and logistic regression were used to identify factors associated with risk of death and a combined endpoint of death or disability at treatment completion...
October 18, 2016: BMC Infectious Diseases
Ram S Kaulgud
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Tharun Tom Oommen, R Madhumathi, Asif Ali
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
R Solomons, M Grantham, B J Marais, R van Toorn
BACKGROUND: The diagnosis of tuberculous meningitis (TBM) in children is often delayed, with disastrous consequences. The Integrated Management of Childhood Illness (IMCI) strategy aims to ensure the accurate assessment of ill children using simple yet reliable clinical signs. METHODS: We conducted a retrospective observational study of 30 consecutive children aged 3 months to 5 years diagnosed with TBM at Tygerberg Hospital, Cape Town, South Africa. Clinical records were reviewed to assess diagnostic delay and identify IMCI indicators that were present at the time of initial presentation...
October 2016: International Journal of Tuberculosis and Lung Disease
Mei-Ling Sharon Tai, Vijay K Sharma
BACKGROUND: Vascular complications are important causes of cerebral infarction in tuberculous meningitis (TBM).Transcranial Doppler ultrasonography (TCD) is a non-invasive tool that can provide real-time information about cerebral hemodynamics. However, the literature on the role of TCD in the diagnosis or monitoring of vasculopathy associated with TBM is scarce. We explored the role of TCD in the diagnosis and monitoring of TBM-related vasculopathy of the major intracranial arteries...
2016: PloS One
Kavitha Kumar, Prashant Giribhattanavar, Nagarathna Chandrashekar, Shripad Patil
Drug resistance has increased the difficulties in control of tuberculosis infection. The present study evaluated the clinical and laboratory features among tuberculous meningitis (TBM) patients and the drug susceptibility of Mycobacterium tuberculosis (M.tb) isolated from CSF. Out of 698 CSF samples, 176 (25.21%) were M.tb culture positive. Among the clinical signs and symptoms, fever, headache and altered sensorium were found to be statistically significant (P<0.05). ELISA was a better predictor of disease and found to be statistically significant (P<0...
September 24, 2016: Diagnostic Microbiology and Infectious Disease
Yad R Yadav, Vijay S Parihar, Mina Todorov, Yatin Kher, Ishwar D Chaurasia, Sonjjay Pande, Hemant Namdev
Hydrocephalus is one of the commonest complications of tuberculous meningitis (TBM). It can be purely obstructive, purely communicating, or due to combinations of obstruction in addition to defective absorption of cerebrospinal fluid (CSF). Endoscopic third ventriculostomy (ETV) as an alternative to shunt procedures is an established treatment for obstructive hydrocephalus in TBM. ETV in TBM hydrocephalus can be technically very difficult, especially in acute stage of disease due to inflamed, thick, and opaque third ventricle floor...
October 2016: Asian Journal of Neurosurgery
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
Erika Britz, Olga Perovic, Claire von Mollendorf, Anne von Gottberg, Samantha Iyaloo, Vanessa Quan, Verushka Chetty, Charlotte Sriruttan, Nazir A Ismail, Ananta Nanoo, Alfred Musekiwa, Carl Reddy, Karien Viljoen, Cheryl Cohen, Nelesh P Govender
INTRODUCTION: Meningitis is a major cause of mortality in southern Africa. We aimed to describe the aetiologies and frequencies of laboratory-confirmed fungal and bacterial meningitis among adults in a South African province with an 11% HIV prevalence, over 4 years. METHODS: We conducted a retrospective, observational study of secondary laboratory data, extracted on all cerebrospinal fluid (CSF) specimens submitted to public-sector laboratories in Gauteng province from 2009 through 2012...
2016: PloS One
Yasemin Cag, Derya Ozturk-Engin, Serap Gencer, Rodrigo Hasbun, Gonul Sengoz, Alexandru Crisan, Nurgul Ceran, Branislava Savic, Kadriye Yasar, Filiz Pehlivanoglu, Gamze Kilicoglu, Hulya Tireli, Ayse S Inal, Rok Civljak, Recep Tekin, Nazif Elaldi, Aysegul Ulu-Kilic, Muge Ozguler, Mustafa Namiduru, Mustafa Sunbul, Oguz R Sipahi, Olga Dulovic, Selma Alabay, Ayhan Akbulut, Alper Sener, Botond Lakatos, Katell Andre, Mucahit Yemisen, Serkan Oncu, Mihai Nechifor, Ozcan Deveci, Seniha Senbayrak, Asuman Inan, Gorana Dragovac, Hanefi C G L, Gurkan Mert, Oral Oncul, Bahar Kandemir, Serpil Erol, Canan Agalar, Hakan Erdem
AIMS: There is no report on the factors affecting the resolution of symptoms related to meningitis during treatment of tuberculous meningitis (TBM). Thus, we examined the factors associated with early therapeutic responses. MATERIALS AND METHODS: This multicenter study included 507 patients with microbiologically confirmed TBM. However, 94 patients eligible for the analysis were included in this study from 24 centers. Six out of 94 patients died and the statistical analysis was performed with 88 survivors...
September 2016: Neurology India
Rakesh Kumar Gupta
No abstract text is available yet for this article.
September 2016: Neurology India
Pradeep Kumar Maurya, Ajai Kumar Singh, Lalit Sharma, Dinkar Kulshreshtha, Anup Kumar Thacker
Ophthalmological complications are common and disabling in patients with tuberculous meningitis. We aimed to study the visual pathway abnormalities in patients with tuberculous meningitis. Forty-three patients with tuberculous meningitis were subjected to visual evoked responses (VER) and neuroophthalmologic assessment. Neuroophthalmologic assessment revealed abnormalities in 22 (51.3%) patients. VER were found to be abnormal in 27 (62.8%) patients. The VER abnormalities included prolonged P100 latencies with relatively normal amplitude and significant interocular latency differences...
November 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Teoman Aydın, Özgür Taşpınar, Yasar Keskin, Müge Kepekçi, Meryem Güneşer, Adil Çamlı, Hakan Seyithanoğlu, Huriye Kızıltan, Ali Hikmet Eriş
BACKGROUND: Tuberculous radiculomyelitis(TBRM) is one of the complications of neurological tuberculosis and includes cases of arachnoiditis, intradural spinal tuberculoma or granuloma, and spinal cord complications of tuberculous meningitis (TBM). Here, we report a case of TBRM which presented with acute paraplegia. CASE DETAILS: Neurological examination on admission revealed flaccid paralysis, bilateral extensor plantar responses, and exaggerated deep tendon reflexes...
July 2016: Ethiopian Journal of Health Sciences
Sophie Jullien, Hannah Ryan, Manish Modi, Rohit Bhatia
BACKGROUND: Tuberculous meningitis (TBM) is the main form of tuberculosis that affects the central nervous system and is associated with high rates of death and disability. Most international guidelines recommend longer antituberculous treatment (ATT) regimens for TBM than for pulmonary tuberculosis disease to prevent relapse. However, longer regimens are associated with poor adherence, which could contribute to increased relapse, development of drug resistance, and increased costs to patients and healthcare systems...
September 1, 2016: Cochrane Database of Systematic Reviews
Noraini Philip, Kenneth Francis Rodrigues, Timothy William, Daisy Vanitha John
Mycobacterium tuberculosis (M. tuberculosis) is the causative agent of tuberculosis (TB) that causes millions of death every year. We have sequenced the genome of M. tuberculosis isolated from cerebrospinal fluid (CSF) of a patient diagnosed with tuberculous meningitis (TBM). The isolated strain was referred as M. tuberculosis SB24. Genomic DNA of the M. tuberculosis SB24 was extracted and subjected to whole genome sequencing using PacBio platform. The draft genome size of M. tuberculosis SB24 was determined to be 4,452,489 bp with a G + C content of 65...
September 2016: Genomics Data
Sunil Prasad Lekhak, Laxmi Sharma, Reema Rajbhandari, Pravesh Rajbhandari, Resha Shrestha, Basant Pant
Tuberculous meningitis (TBM) is one of those most serious manifestations of extra-pulmonary tuberculosis and prompt diagnosis and treatment is required for better clinical outcome. It is difficult to diagnose due to lack of rapid, sensitive, and specific tests. Newer methods, which are easy and reliable, are required to diagnose TBM at an early stage. Thus our aim was to evaluate the Multiplex polymerase chain reaction (PCR) technique, using primers directed against the insertion sequence IS6110 and MPB64 gene for the detection of Mycobacterium tuberculosis in Cerebrospinal fluid (CSF), for rapid diagnosis of TBM patients...
September 2016: Tuberculosis
Amna Jawaid, Surriya Bano, Anwar Ul Haque, Khubaib Arif
Meningitis is a leading cause of morbidity and mortality worldwide in intensive care settings. The aim of this study was to assess the frequency and outcome in children with meningitis through a retrospective chart review done in pediatric intensive care unit of a tertiary care hospital from January 2000 to December 2014. During these 14 years, 64 patients were admitted with meningitis in pediatric intensive care unit. Out of 64, 36 were diagnosed with pyogenic meningitis, 18 patients with viral meningitis, and 10 with tuberculous meningitis...
August 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Vycke Yunivita, Sofiati Dian, Ahmad Rizal Ganiem, Ela Hayati, Tri Hanggono Achmad, Atu Purnama Dewi, Marga Teulen, Petra Meijerhof-Jager, Reinout van Crevel, Rob Aarnoutse, Rovina Ruslami
High-dose intravenous (i.v.) rifampicin improved the outcome of tuberculous meningitis (TBM) in a previous study. Unfortunately, i.v. rifampicin is not available in many high-endemic settings. This study examined exposures to and safety of higher oral rifampicin doses compared with i.v. rifampicin. Thirty adult Indonesian TBM patients were randomised to rifampicin 750 mg (ca. 17 mg/kg) orally, 900 mg (ca. 20 mg/kg) orally or 600 mg (ca. 13 mg/kg, as used previously) i.v. over 1.5 h for 14 days, combined with other TB drugs...
October 2016: International Journal of Antimicrobial Agents
Takashi Fujii, Naoki Otani, Yohei Otsuka, Takashi Matsumoto, Shunsuke Tanoue, Hideaki Ueno, Satoshi Tomura, Arata Tomiyama, Terushige Toyooka, Kojiro Wada, Kentaro Mori
We herein report a surgical case of multiple cerebral calculi located within the chiasmatic cistern resulting in visual disturbance. A 61-year-old man experienced homonymous lower right quadrantanopsia a few years prior. Non-enhanced head CT revealed multiple calcified lesions of about 7-mm within the basal cistern. MRI showed the lesion compressing the left optic tract. We could not remove the entire lesion because of severe adhesion to the optic tract. A pathological test showed calcified lesions with lymphocyte infiltration...
August 2016: No Shinkei Geka. Neurological Surgery
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