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tuberculous meningitis

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https://www.readbyqxmd.com/read/27899068/title-role-of-matrix-metalloproteinase-9-in-progression-of-tuberculous-meningitis-a-pilot-study-in-patients-at-different-stages-of-the-disease
#1
S Majeed, P Singh, N Sharma, S Sharma
BACKGROUND: TBM (Tuberculous meningitis) is severe form of tuberculosis causing death of one third of the affected individuals or leaving two-third of the survivors disabled. MMP-9 (Matrix metalloproteinase-9) is produced by the central nervous system in a variety of inflammatory conditions and has a role in the breakdown of extracellular matrix and blood-brain barrier. METHODS: In this study, the levels of MMP-9 and its inhibitor, TIMP-1 (tissue inhibitor of metalloproteinases-1), were screened using zymography and reverse zymography in cerebrospinal fluid and serum of tuberculous meningitis patients at different stages of the disease...
November 29, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27895360/paediatric-external-ventricular-drains-experience-from-a-tertiary-care-hospital-of-a-developing-country
#2
Abbas Qalab, Rayaan Asad, Mahnaz Hakeem, Maria Ahmed, Haque Anwar, Aneela Darbar
The aim of the study was to describe indications and complications of external ventricular drain (EVD) placement in children aged between 1 month and 16 years. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised all children who underwent EVD placement from January 2007 to December 2014. Of the 177 patients identified, 117(66%) were males 60(34%) were girls. The overall mean age was 5.4±5.2 years. The median Glasgow Coma Scale score on presentation and discharge was 13 (interquartile range [IQR]: 7) and 15 (IQR: 4), respectively...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27865204/possible-role-of-transforming-growth-factor-%C3%AE-in-tuberculous-meningitis
#3
J Kalita, U K Misra, S K Bhoi, P S Chauhan, Betai Sagar
BACKGROUND: Transforming growth factor β (TGF-β) is an anti-inflammatory cytokine and its role in hydrocephalus and stoke has been suggested. Tuberculous meningitis (TBM) is associated with exudates, stroke, hydrocephalus and tuberculoma, but the role of TGF-β has not been evaluated in relation to these changes. AIM: To evaluate the cerebrospinal fluid (CSF) TGF-β level in the patients with TBM, and correlate these with clinical findings, MRI changes, paradoxical response and outcome at 6months...
November 16, 2016: Cytokine
https://www.readbyqxmd.com/read/27857783/hyponatremia-in-children-with-tuberculous-meningitis-a-hospital-based-cohort-study
#4
Prithi Inamdar, Sanjeevani Masavkar, Preeti Shanbag
BACKGROUND: Hyponatremia has long been recognized as a potentially serious metabolic consequence of tuberculous meningitis (TBM) occurring in 35-65% of children with the disease. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has for long been believed to be responsible for the majority of cases of hyponatremia in TBM. Cerebral salt wasting syndrome (CSWS) is being increasingly reported as a cause of hyponatremia in some of these children. AIM: This study was done to determine the frequency and causes of hyponatremia in children with TBM...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27834596/ventriculo-ureteral-shunt-insertion-using-percutaneous-nephrostomy-a-novel-minimally-invasive-option-in-a-patient-with-chronic-hydrocephalus-complicated-by-multiple-distal-ventriculoperitoneal-shunt-failures
#5
Ashok Pillai, Georgie Mathew, Sivasankaran Nachimuthu, Sanjeevan Vasudevan Kalavampara
The management of ventriculoperitoneal (VP) shunt failure is a common problem in neurosurgical practice. On occasion, extraperitoneal sites for CSF diversion are required when shunting to the peritoneal cavity has failed after multiple attempts. The authors report a novel minimally invasive procedure allowing cannulation of the ureter for the purpose of ventriculo-ureteral (VU) shunting. Sixteen years prior to presentation, this 46-year-old woman had contracted tuberculous meningitis and had chronic hydrocephalus, with multiple distal shunt failures in recent months...
November 11, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27823900/gene-based-neonatal-immune-priming-potentiates-a-mucosal-adenoviral-vaccine-encoding-mycobacterial-ag85b
#6
Guixiang Dai, Hamada F Rady, Weitao Huang, Judd E Shellito, Carol Mason, Alistair J Ramsay
Tuberculosis remains a major public health hazard worldwide, with neonates and young infants potentially more susceptible to infection than adults. BCG, the only vaccine currently available, provides some protection against tuberculous meningitis in children but variable efficacy in adults, and is not safe to use in immune compromised individuals. A safe and effective vaccine that could be given early in life, and that could also potentiate subsequent booster immunization, would represent a significant advance...
December 7, 2016: Vaccine
https://www.readbyqxmd.com/read/27822198/looks-like-tuberculous-meningitis-but-not-a-case-of-rhinocerebral-mucormycosis-with-garcin-syndrome
#7
HongNa Yang, CuiLan Wang
Rhinocerebral mucomycosis (RCM) as an emerging opportunistic, angioinvasive, and devastating fungi infection with high mortality is difficult to be diagnosed early because of the lack of specific clinical features or manifestations. Garcin syndrome is more often caused by skull base and rhinopharyngeal tumors or metastases, and basal meningitis. We reported that an aged diabetic man, involved nearly all cranial nerves (Garcin syndrome), who was at first suspected to be suffered from tuberculous meningitis, ultimately developed typically progressing RCM...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27807490/a-case-of-tuberculous-meningitis-with-paradoxical-response-in-a-14-year-old-boy
#8
Murat Özer, Yasemin Özsürekci, Ali Bülent Cengiz, Nagehan Emiralioğlu, Deniz Doğru, Kader Karlı Oğuz, Onur Akça, Özgür Özkayar
A clinical or radiological worsening of already existing lesions or an emergence of new lesions after beginning treatment in patients with tuberculosis (TB) is referred to as the paradoxical response. This has aroused suspicion regarding the accuracy of diagnosis, the possibilities of treatment failure, or the presence of another underlying disease, and thus it is an important topic for clinicians to understand. In this article, the development of a paradox reaction in a 14-year-old male patient diagnosed with and treated for tuberculosis meningitis is reported...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27798497/recent-advances-in-the-diagnosis-and-management-of-tuberculous-meningitis
#9
Nguyen T H Mai, Guy E Thwaites
PURPOSE OF REVIEW: Tuberculous meningitis is a devastating infection that is hard to diagnose and treat. We have reviewed tuberculous meningitis original research published within the past 18 months, selecting studies which we consider have most advanced knowledge. RECENT FINDINGS: We review advances in diagnostic methods, anti-tuberculosis chemotherapy, and the common complications of tuberculous meningitis. New commercial molecular diagnostic tests, such as GeneXpert MTB/RIF, have an important role in tuberculous meningitis diagnosis, but as with all other available tests, they lack sensitivity and cannot rule out the disease...
October 27, 2016: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/27795917/hmgb1-level-in-cerebrospinal-fluid-as-a-complimentary-biomarker-for-the-diagnosis-of-tuberculous-meningitis
#10
Yan Chen, Jun Zhang, Xiaofei Wang, Yu Wu, Li Zhu, Longkun Lu, Qian Shen, Yanghua Qin
PURPOSE: High mobility group box-1 (HMGB1) is a proinflammatory, DAMP protein that participates in many pathological conditions. In this study, we evaluated the usability of CSF HMGB1 as a biomarker for the diagnosis of tuberculous meningitis (TBM). METHODS: A total of 59 TBM patients and 169 control patients were included in our study. CSF samples were obtained and analyzed for HMGB1 using a commercial ELISA kit. RESULTS: The mean CSF HMGB1 was 19...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27786246/hiv-associated-opportunistic-cns-infections-pathophysiology-diagnosis-and-treatment
#11
REVIEW
Lauren N Bowen, Bryan Smith, Daniel Reich, Martha Quezado, Avindra Nath
Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis...
October 27, 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27776580/need-for-combined-interventions-and-operational-research-to-tackle-tuberculous-meningitis
#12
Giovanni Ferrara
No abstract text is available yet for this article.
November 2016: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/27772758/role-of-18-f-fdg-pet-in-demonstrating-disease-burden-in-patients-with-tuberculous-meningitis
#13
Sanjay Gambhir, Mritunjai Kumar, Mudalsha Ravina, Sanjeev Kumar Bhoi, Jayantee Kalita, U K Misra
OBJECTIVE: To study the role of (18)fluoro-deoxy glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) scan in documenting the disease burden in patients with tuberculous meningitis (TBM), and compare these findings with conventional imaging and magnetic resonance imaging (MRI). SUBJECTS AND METHODS: Ten patients with definite TBM were prospectively recruited. The severity of TBM was graded into stage I to III. The patients were subjected to whole body (18)F-FDG PET/CT imaging and MRI brain...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27772738/validation-of-thwaites-index-for-diagnosing-tuberculous-meningitis-in-a-colombian-population
#14
Juan Sebastián Saavedra, Sebastián Urrego, María Eugenia Toro, Carlos Santiago Uribe, Jenny García, Olga Hernández, Juan Carlos Arango, Ángela Beatriz Pérez, Andrés Franco, Isabel Cristina Vélez, Helena Del Corral
OBJECTIVE: To determine the diagnostic accuracy of Thwaites Index (TI) in a Colombian population to distinguish meningeal tuberculosis (MTB) from bacterial meningitis (BM) and from non-tuberculous meningitis. Exploratory analyses were conducted to assess the TI's validity for patients with human immunodeficiency virus (HIV) and children above six-years-old. METHODS: The study included 527 patients, the TI was calculated and results compared with those of a reference standard established by expert neurologists...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27758813/tuberculous-meningitis-in-an-immunocompetent-male-complicated-by-hydrocephalus
#15
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
https://www.readbyqxmd.com/read/27756256/clinical-presentations-diagnosis-mortality-and-prognostic-markers-of-tuberculous-meningitis-in-vietnamese-children-a-prospective-descriptive-study
#16
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
https://www.readbyqxmd.com/read/27728455/cd4-count-in-patients-with-hiv-and-tuberculous-meningitis-coinfection-a-perfect-surrogate-marker-of-disease-severity
#17
Ram S Kaulgud
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27728441/choroidal-tubercles-in-tuberculous-meningitis
#18
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
https://www.readbyqxmd.com/read/27725040/imci-indicators-of-childhood-tbm-at-primary-health-care-level-in-the-western-cape-province-of-south-africa
#19
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
https://www.readbyqxmd.com/read/27723828/role-of-transcranial-doppler-in-the-evaluation-of-vasculopathy-in-tuberculous-meningitis
#20
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
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