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https://www.readbyqxmd.com/read/29133710/role-of-preoperative-imaging-in-the-diagnosis-of-primary-diffuse-craniospinal-leptomeningeal-gliomatosis
#1
Jayant Vishal, Rana Patir, Sunita Ahlawat, Rakesh K Gupta
We present an unusual case of primary diffuse craniospinal leptomeningeal gliomatosis (PGDL), who was initially diagnosed on the basis of imaging, laboratory findings, and cranial meningeal biopsy as tuberculous meningitis and showed clinical deterioration while on anti-tuberculous treatment for 2 months. The patient was subsequently correctly diagnosed on diffusion weighted and post-contrast T1-weighted imaging of the craniospinal axis along with whole body imaging. The radiological findings were confirmed on histopathology and immunohistochemistry performed from the previous block as well as biopsy from the nodular mass in the lumbosacral meninges...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29084241/novel-approach-based-on-one-tube-nested-pcr-and-a-lateral-flow-strip-for-highly-sensitive-diagnosis-of-tuberculous-meningitis
#2
Yajuan Sun, Jiajun Chen, Jia Li, Yawei Xu, Hui Jin, Na Xu, Rui Yin, Guohua Hu
Rapid and sensitive detection of Mycobacterium tuberculosis (M. Tb) in cerebrospinal fluid is crucial in the diagnosis of tuberculous meningitis (TBM), but conventional diagnostic technologies have limited sensitivity and specificity or are time-consuming. In this work, a novel, highly sensitive molecular diagnostic method, one-tube nested PCR-lateral flow strip test (OTNPCR-LFST), was developed for detecting M. tuberculosis. This one-tube nested PCR maintains the sensitivity of conventional two-step nested PCR and reduces both the chance of cross-contamination and the time required for analysis...
2017: PloS One
https://www.readbyqxmd.com/read/29081366/central-nervous-system-infections-in-the-absence-of-cerebrospinal-fluid-pleocytosis
#3
Hakan Erdem, Derya Ozturk-Engin, Yasemin Cag, Seniha Senbayrak, Asuman Inan, Esra Kazak, Umit Savasci, Nazif Elaldi, Haluk Vahaboglu, Rodrigo Hasbun
Previous multicenter/multinational studies were evaluated to determine the frequency of the absence of cerebrospinal fluid pleocytosis in patients with central nervous system infections, as well as the clinical impact of this condition. It was found that 18% of neurosyphilis, 7.9% of herpetic meningoencephalitis, 3% of tuberculous meningitis, 1.7% of Brucella meningitis, and 0.2% of pneumococcal meningitis cases did not display cerebrospinal fluid pleocytosis. Most patients were not immunosuppressed. Patients without pleocytosis had a high rate of unfavorable outcomes and thus this condition should not be underestimated...
November 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29078126/differential-diagnosis-of-scrub-typhus-meningitis-from-tuberculous-meningitis-using-clinical-and-laboratory-features
#4
Ashraf V Valappil, Sohanlal Thiruvoth, Jabir M Peedikayil, Praveenkumar Raghunath, Manojan Thekkedath
OBJECTIVES: The involvement of the central nervous system in the form of meningitis or meningoencephalitis is common in scrub typhus and is an important differential diagnosis of other lymphocytic meningitis like tuberculous meningitis (TBM). The aim of this study was to identify the clinical and laboratory parameters that may be helpful in differentiating scrub typhus meningitis from TBM. PATIENTS AND METHODS: We compared of the clinical and laboratory features of 57 patients admitted with scrub typhus meningitis or TBM during a 3-year period...
October 23, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29061204/a-spatial-and-temporal-analysis-of-paediatric-central-nervous-system-infections-from-2005-to-2015-in-ho-chi-minh-city-vietnam
#5
N T Ho, V M T Hoang, N N T LE, D T Nguyen, A Tran, D Kaki, P M Tran, C N Thompson, M N Q Ngo, K H Truong, H T Nguyen, T M Ha, C V V Nguyen, G E Thwaites, K T Thakur, D Hesdorffer, S Baker
Central nervous system infections (CNSI) are a leading cause of death and long-term disability in children. Using ICD-10 data from 2005 to 2015 from three central hospitals in Ho Chi Minh City (HCMC), Vietnam, we exploited generalized additive mixed models (GAMM) to examine the spatial-temporal distribution and spatial and climatic risk factors of paediatric CNSI, excluding tuberculous meningitis, in this setting. From 2005 to 2015, there were 9469 cases of paediatric CNSI; 33% were ⩽1 year old at admission and were mainly diagnosed with presumed bacterial CNSI (BI) (79%), the remainder were >1 year old and mainly diagnosed with presumed non-bacterial CNSI (non-BI) (59%)...
October 24, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/29033887/atypical-cerebral-manifestations-of-disseminated-mycobacterium-tuberculosis
#6
Ji Hye Hwang, Kyung Mi Lee, Ji Eun Park, Hyug-Gi Kim, Eui Jong Kim, Woo Suk Choi, Na Rae Yang
BACKGROUND: We investigated the patterns of cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis or disseminated tuberculosis. MATERIALS AND METHODS: From January 2010 to September 2016, brain magnetic resonance imaging (MRI) scans were obtained to evaluate cerebral manifestations in patients with underlying pulmonary or extrapulmonary tuberculosis. We also included patients with drug-resistant tuberculosis or disseminated tuberculosis...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29033632/review-of-viral-encephalitis-cases-seen-at-a-tertiary-care-center-in-turkey-focus-on-herpes-simplex-type-1
#7
Beyza Çiftçi Kavaklioğlu, Eda Çoban, Aysu Şen, Elif Söylemezoğlu, Mehmet Ali Aldan, Dilek Atakli, Aysun Soysal
INTRODUCTION: The objective of this study was to determine the incidence of herpes simplex encephalitis (HSE), known as the most common, potentially mortal, and treatable cause of sporadic encephalitis, in a sample Turkish population. METHODS: The demographic, clinical, laboratory, imaging, electrophysiology, and polymerase chain reaction (PCR) DNA results of patients examined with a pre-diagnosis of encephalitis were retrospectively examined. RESULTS: A total of 68 patients were included in the study...
September 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29029055/prognostic-models-for-9-month-mortality-in-tuberculous-meningitis
#8
Le Thi Phuong Thao, A Dorothee Heemskerk, Ronald B Geskus, Nguyen Thi Hoang Mai, Dang Thi Minh Ha, Tran Thi Hong Chau, Nguyen Hoan Phu, Nguyen Van Vinh Chau, Maxine Caws, Nguyen Huu Lan, Do Dang Anh Thu, Nguyen Thuy Thuong Thuong, Jeremy Day, Jeremy J Farrar, M Estee Torok, Nguyen Duc Bang, Guy E Thwaites, Marcel Wolbers
Background: Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis. We developed and validated prognostic models for 9-month mortality in HIV-uninfected and HIV-infected adults with TBM. Methods: We included 1699 subjects from four randomized clinical trials and one prospective observational study conducted at two major referral hospitals in Southern Vietnam from 2001-2015. Modelling was based on multivariable Cox proportional hazards regression...
September 26, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29018323/cerebrospinal-fluid-amino-acid-profiling-of-pediatric-cases-with-tuberculous-meningitis
#9
Shayne Mason, Carolus J Reinecke, Regan Solomons
Background: In Africa, tuberculosis is generally regarded as persisting as one of the most devastating infectious diseases. The pediatric population is particularly vulnerable, with infection of the brain in the form of tuberculous meningitis (TBM) being the most severe manifestation. TBM is often difficult to diagnose in its early stages because of its non-specific clinical presentation. Of particular concern is that late diagnosis, and subsequent delayed treatment, leads to high risk of long-term neurological sequelae, and even death...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28975967/application-value-of-procalcitonin-in-patients-with-central-nervous-system-infection
#10
X-F Zhang, X-Q Zhang, C-C Wu, H-W Wu, D Wei
OBJECTIVE: To study the application value of procalcitonin (PCT) in patients with central nervous system (CNS) infection. PATIENTS AND METHODS: A total of 66 patients, including 24 patients with suppurative meningitis, 20 patients with viral meningitis and 22 patients with tuberculous meningitis, were enrolled. 20 patients admitted to the hospital due to epilepsy or headache without infection in the same period were enrolled as the control group. PCT, high-sensitivity C-reactive protein (Hs-CRP), high-sensitivity C-reactive protein (Hs-CRP), protein quantification, chloride and glucose in serum and cerebrospinal fluid, were collected...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28970078/evaluation-of-cerebral-arterial-and-venous-system-in-tuberculous-meningitis
#11
Jayantee Kalita, Rajesh K Singh, Usha K Misra, Sunil Kumar
BACKGROUND: Central nervous system infection especially pyogenic results in cerebral venous sinus thrombosis. Tuberculous meningitis (TBM) although associated with infarctions but there is no comprehensive study evaluating the role of CVST contributing in infarction. PURPOSE: To evaluate cerebral arterial and venous system using MR angiography (MRA) and MR venography (MRV) in TBM, and correlate with clinical and MRI findings. MATERIALS AND METHODS: Consecutive patients with TBM were evaluated clinically and their consciousness was assessed by using Glasgow Coma scale...
September 29, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28964954/a-rapid-and-simple-resazurin-assay-to-detect-minimum-inhibitory-concentration-for-first-line-drugs-of-mycobacterium-tuberculosis-isolated-from-cerebrospinal-fluid
#12
Kavitha Kumar, Prashant Giribhattanavar, Chandrasekhar Sagar, Shripad Patil
INTRODUCTION: Central nervous system tuberculosis (CNS-TB) is a devastating manifestation of TB. The most common form of CNS-TB is tuberculous meningitis (TBM). Drug-resistant TB poses a major threat to the control of TB worldwide. Timely treatment dramatically improves the outcome. Colorimetric techniques based on oxidation-reduction principle for drug susceptibility testing gives results quick and less expensive. OBJECTIVE: The objectives were to compare four first-line drugs' susceptibility of Mycobacterium tuberculosis isolated from cerebrospinal fluid by Mycobacteria growth indicator tube (MGIT) and resazurin assay (RA), also to estimate the minimum inhibitory concentration values by RA...
September 27, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28941861/concurrent-intramedullary-spinal-cord-and-multiple-intracranial-tuberculomas-with-tuberculous-optic-neuritis-a-rare-case-report
#13
Lulup Sahoo, Ashok Kumar Mallick, Geeta Mohanty, Kali Prasanna Swain, Soumyadarshan Nayak, Ashwini Kumar Sahu
Tuberculosis (TB) remains a worldwide burden, with a large majority of new active TB cases occurring in underdeveloped and developing countries. Tuberculous meningitis (TBM) is one of the common infections of central nervous system. Other manifestations include intracranial tuberculoma, tubercular brain abscess, spinal tuberculoma, and granulomatous arachnoiditis. Visual impairment in TBM may be due to optic neuritis, optochiasmatic arachnoiditis (OCA), tuberculoma in the chiasmatic region or in the optic pathways, chorioretinitis, secondary to hydrocephalus and increased intracranial pressure, and finally due to ethambutol toxicity...
October 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28941852/predictors-of-adverse-outcome-in-patients-of-tuberculous-meningitis-in-a-multi-centric-study-from-india
#14
Renu Gupta, Suman Kushwaha, Rajeev Thakur, Nupur Jalan, Pumanshi Rawat, Piyush Gupta, Amitesh Aggarwal, Meena Gupta, Vikas Manchanda
INTRODUCTION: This study aimed to investigate the factors which may predict mortality and neurological disability at one year follow up in patients of tuberculous meningitis (TBM) in India. METHODOLOGY: Patients with TBM were prospectively enrolled from July 2012 to September 2014 from four tertiary care hospitals of Delhi. The demographic characteristics, clinical features and laboratory findings were collected and patients were followed up till 1 year. These were analyzed by univariate and multivariate multinomial logistic regression analysis to identify predictors of adverse patient outcome at 1 year follow up...
October 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28932979/tuberculous-meningitis-in-children-and-adults-new-insights-for-an-ancient-foe
#15
REVIEW
Alyssa Mezochow, Kiran Thakur, Christopher Vinnard
PURPOSE OF REVIEW: Tuberculous meningitis is the most devastating manifestation of infection with Mycobacterium tuberculosis and represents a medical emergency. Approximately one half of tuberculous meningitis patients die or suffer severe neurologic disability. The goal of this review will be to review the pathogenic, clinical, and radiologic features of tuberculous meningitis and to highlight recent advancements in translational and clinical science. RECENT FINDINGS: Pharmacologic therapy includes combination anti-tuberculosis drug regimens and adjunctive corticosteroids...
September 20, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28928997/neurosyphilis-with-concomitant-cryptococcal-and-tuberculous-meningitis-in-a-patient-with-aids-report-of-a-unique-case
#16
Jose Armando Gonzales Zamora, Luis Alberto Espinoza, Rita N Nwanyanwu
Meningitis in individuals living with acquired immunodeficiency syndrome (AIDS) is most frequently infectious in origin and usually due to opportunistic infections. The most common pathogens are Cryptococcus neoformans and Mycobacterium tuberculosis. Treponema pallidum causes neurosyphilis and can complicate HIV infections at any time after the initial infection. Simultaneous infections of the central nervous system caused by these pathogens are very uncommon even in the setting of severe immunosuppression...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28919338/diagnostic-accuracy-of-xpert-mtb-rif-ultra-for-tuberculous-meningitis-in-hiv-infected-adults-a-prospective-cohort-study
#17
Nathan C Bahr, Edwin Nuwagira, Emily E Evans, Fiona V Cresswell, Philip V Bystrom, Adolf Byamukama, Sarah C Bridge, Ananta S Bangdiwala, David B Meya, Claudia M Denkinger, Conrad Muzoora, David R Boulware
BACKGROUND: WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with Xpert sensitivity of about 50-70% and culture sensitivity of about 60%. We evaluated the diagnostic performance of the new Xpert MTB/RIF Ultra (Xpert Ultra) for tuberculous meningitis. METHODS: We prospectively obtained diagnostic cerebrospinal fluid (CSF) specimens during screening for a trial on the treatment of HIV-associated cryptococcal meningitis in Mbarara, Uganda...
September 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28919337/xpert-mtb-rif-ultra-a-gamechanger-for-tuberculous-meningitis
#18
Margaret Khonga, Mark Patrick Nicol
No abstract text is available yet for this article.
September 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28915693/the-application-of-is6110-baced-loop-mediated-isothermal-amplification-lamp-in-the-early-diagnosis-of-tuberculous-meningitis
#19
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...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28911358/performance-of-nested-rt-pcr-on-csf-for-tuberculous-meningitis-diagnosis-in-hiv-infected-patients
#20
F A S Gualberto, M G Gonçalves, L O Fukasawa, A M Ramos Dos Santos, C T Sacchi, L H Harrison, D R Boulware, J E Vidal
SETTING: Timely diagnosis of tuberculous meningitis (TBM) in patients with human immunodeficiency virus (HIV) infection remains a challenge. Despite the current scale-up of the Xpert® MTB/RIF assay, other molecular diagnostic tools are necessary, particularly in referral centres in low- and middle-income countries without Xpert testing. OBJECTIVE: To determine the diagnostic performance of nested real-time polymerase chain reaction (nRT-PCR) in HIV-infected TBM patients categorised according to standardised clinical case definitions...
October 1, 2017: International Journal of Tuberculosis and Lung Disease
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