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meningeal tuberculosis

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https://www.readbyqxmd.com/read/28919338/diagnostic-accuracy-of-xpert-mtb-rif-ultra-for-tuberculous-meningitis-in-hiv-infected-adults-a-prospective-cohort-study
#1
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/28915813/the-relationship-between-burden-of-childhood-disease-and-foreign-aid-for-child-health
#2
J Clay Bavinger, Paul Wise, Eran Bendavid
BACKGROUND: We sought to examine the relationship between child specific health aid (CHA) and burden of disease. Based on existing evidence, we hypothesized that foreign aid for child health would not be proportional to burden of disease. METHODS: In order to examine CHA and burden of disease, we obtained estimates of these parameters from established sources. Estimates of disability adjusted life years (DALYs) in children (0-5 years) were obtained from the World Health Organization for 2000 and 2012...
September 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28915693/the-application-of-is6110-baced-loop-mediated-isothermal-amplification-lamp-in-the-early-diagnosis-of-tuberculous-meningitis
#3
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/28904730/-tuberculous-meningoencephalitis-revealed-by-psychiatric-disorders-about-a-case
#4
Khalid Mouhadi, Tarik Boulahri, Abdelhadi Rouimi
Tuberculous meningoencephalitis is fairly frequent in endemic countries and it is the most severe form of tuberculosis. Therapeutic failure is common because of diagnostic delay. This delay is primarily due to a wide clinical polymorphism and, in particular, to misleading forms. We here report a rare clinical case of tuberculous meningitis in a patient in prodromal phase of psychosis.
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28895024/tuberculosis-meningitis
#5
REVIEW
Kassem Bourgi, Christina Fiske, Timothy R Sterling
PURPOSE OF REVIEW: As the most severe form of tuberculosis (TB), TB meningitis disproportionately affects developing countries and results in significant morbidity and mortality. In this report, we review recent updates in the epidemiology, diagnosis, and management of TB meningitis. RECENT FINDINGS: Young children and people living with HIV continue to be at highest risk for TB meningitis. Early diagnosis remains challenging, especially since conventional diagnostic tests have sub-optimal sensitivity and specificity...
September 11, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28884751/tuberculous-meningitis
#6
REVIEW
Robert J Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E Thwaites
Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation...
September 8, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28882017/utility-of-rapid-microbiological-techniques-for-the-diagnosis-of-severe-infections
#7
REVIEW
E Cercenado
Rapid diagnostic microbiological techniques and antimicrobial susceptibility testing are necessary for early and adequate treatment. The utility of old (Gram stain, antigen detection, direct antimicrobial susceptibility testing, chromogenic media) and new techniques (molecular assays, MALDI-TOF) is summarized for the rapid diagnosis of bacteraemia and fungaemia, catheter-related bloodstream infections, pneumonia, meningitis, skin and soft-tissue infections, urinary tract infection, Clostridium difficile infection, viral infections, and tuberculosis...
September 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28877182/cryptococcal-antigen-screening-by-lay-cadres-using-a-rapid-test-at-the-point-of-care-a-feasibility-study-in-rural-lesotho
#8
Fernanda Rick, Aline Aurore Niyibizi, Amir Shroufi, Kazumi Onami, Sarah-Jane Steele, Malehlohonolo Kuleile, Innocent Muleya, Tom Chiller, Tiffany Walker, Gilles Van Cutsem
INTRODUCTION: Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC)...
2017: PloS One
https://www.readbyqxmd.com/read/28870736/role-of-rifampin-for-the-treatment-of-bacterial-infections-other-than-mycobacteriosis
#9
REVIEW
Chun-Yuan Lee, Chung-Hao Huang, Po-Liang Lu, Wen-Chien Ko, Yen-Hsu Chen, Po-Ren Hsueh
OBJECTIVES: Rifampin was initially approved for the treatment of tuberculosis. Because of its low toxicity, broad-spectrum activity, and good bioavailability, rifampin is now commonly administered as combination antimicrobial therapy for the treatment of various infections caused by organisms other than mycobacteria. This review summarizes the most recent clinical studies on the use of rifampin combinations for treating four common non-mycobacterial infections: acute bacterial meningitis, infective endocarditis and bacteraemia, pneumonia, and biofilm-related infections...
September 1, 2017: Journal of Infection
https://www.readbyqxmd.com/read/28866263/use-of-multiplex-pcr-based-molecular-diagnostics-in-diagnosis-of-suspected-cns-infections-in-tertiary-care-setting-a-retrospective-study
#10
Mahendra Javali, Purushottam Acharya, Aneesh Mehta, Aju Abraham John, Rohan Mahale, R Srinivasa
OBJECTIVES: CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28843114/clinical-and-radiological-predictors-of-outcome-in-tubercular-meningitis-a-prospective-study-of-209-patients
#11
M Modi, K Sharma, S Prabhakar, M K Goyal, A Takkar, N Sharma, A Garg, S Faisal, N Khandelwal, P Singh, J Sachdeva, R Shree, V Rishi, V Lal
OBJECTIVES: The predictors of poor outcome in tuberculous meningitis (TBM) remain to be delineated. We determined role of various clinical, radiological and cerebrospinal fluid (CSF) parameters in prediction of outcome in TBM. PATIENTS AND METHODS: Current study was a prospective observational study including 209 patients of TBM. All patients underwent detailed evaluation including Gadolinium enhanced Magnetic resonance imaging (GdMRI) of brain as well as tests to detect evidence of tuberculosis elsewhere in body...
August 18, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28831193/tuberculosis-cryptococcosis-co-infection-in-china-between-1965-and-2016
#12
Wenjie Fang, Lei Zhang, Jia Liu, David W Denning, Ferry Hagen, Weiwei Jiang, Nan Hong, Shuwen Deng, Xia Lei, Danqi Deng, Wanqing Liao, Jianping Xu, Teun Boekhout, Min Chen, Weihua Pan
Cases of tuberculosis/cryptococcosis co-infection are rapidly increasing in China. However, most studies addressing this co-infection have been published in Chinese journals, and this publication strategy has obscured this disease trend for scientists in other parts of the world. Our investigation found that 62.9% of all co-infection cases worldwide were reported in the Chinese population (n=197) between 1965 and 2016, and 56.3% of these Chinese cases were reported after 2010. Nearly all cases originated from the warm and wet monsoon regions of China...
August 23, 2017: Emerging Microbes & Infections
https://www.readbyqxmd.com/read/28819046/tuberculous-tales-an-east-london-experience
#13
REVIEW
Apeksha M Shah, Dominika Raciborska, Matthew Stevens, Sharmilee Gnanapavan, Veronica L C White, Benjamin Turner
Tuberculous meningitis presents a diagnostic and therapeutic challenge, and considering its long history and increasing global incidence, the evidence base for its treatment is relatively scanty. Many UK neurologists will have little first-hand experience of this deadly condition, and if faced with a patient with possible tuberculous meningitis will find decision making less than straightforward. In parts of East London (UK) the rates of tuberculosis and tuberculous meningitis are among the highest in Western Europe, and so the neurologists and respiratory physicians at the Royal London Hospital have encountered many such patients over the years...
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28810312/-analysis-of-infection-and-drug-resistance-in-6-107-cases-of-extrapulmonary-tuberculosis-in-chengdu-area
#14
D M Wang, Q F Li, M Zhu, Y H Xu, J Luo, Y J Li, J Zhong, Z J Wu
Objective: To analyze the infection and drug resistance of extrapulmonary tuberculosis, in order to provide useful references for prevention and treatment of tuberculosis (TB). Methods: A total of 6 107 suspected cases of extrapulmonary tuberculosis, including lymph node, pleural, peritoneal, meningeal, urinary tract, and bone tuberculosis, were collected retrospectively from January 2013 to December 2015 in Public Health Clinical Center of Chengdu. There were 4 033 male and 2 074 female patients, and the average age was 37 years...
August 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28805143/a-pre-term-infant-of-32-weeks-gestation-with-congenital-tuberculosis-treated-successfully-with-antituberculosis-chemotherapy
#15
Xiaoyi Fang, Ruizhi Mai, Jizhong Guo, Niyang Lin
An infant of 32 weeks gestation was separated from her mother at birth for treatment of hyaline membrane disease and, on recovery, was cared for by adoptive parents. At 25 days, she was treated for pneumonia with immunoglobulins and multiple antibiotics and appeared to respond. Her symptoms recurred at 8 weeks and tuberculosis was confirmed by detection in an acid-fast bacilli smear of gastric aspirate. Her mother presented with disseminated tuberculosis with meningitis 1 month after delivery. Criteria for the diagnosis of congenital tuberculosis in the infant were confirmed...
August 14, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28794092/optic-disc-swelling-in-a-patient-with-tuberculous-meningitis-a-diagnostic-challenge
#16
Hanis Zuhaimy, Sue Ngein Leow, Suresh K Vasudevan
We discuss the diagnostic challenge in an adult patient presented with purely ocular symptoms diagnosed with tuberculous meningitis (TBM). A 38-year-old woman presented with bilateral painless blurring of vision. There were bilateral sixth cranial nerve palsy and bilateral optic disc swelling. Optic nerve function tests were normal. Patient was lucid with no signs of meningism. Brain imaging were normal. She had a positive Mantoux test, high erythrocyte sedimentation rate but no clinical evidence of active pulmonary tuberculosis infection...
August 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28776527/knowledge-on-tuberculosis-among-the-members-of-a-rural-community-in-myanmar
#17
Kyaw San Lin, Chit Sandy Kyaw, Ye Pyae Sone, Su Yi Win
BACKGROUND: Myanmar, one of the high tuberculosis (TB) burden countries, is in serious need of research work to develop strategies aiming to tackle the problem. Conducting a study on the knowledge of the population will help understand the flaws in the National TB Control Program (NTP), and how to correct them, and further strategic planning to reach the goals of Sustainable Development Goals. AIMS: The aim of the study was to access sociodemographic characteristics, knowledge, and behavioral practice of TB among the community members in Ngar Syu Taung Village, Hlegu Township...
July 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28776526/common-bacterial-isolates-clinical-outcome-and-tb-meningitis-in-children-admitted-at-morogoro-regional-referral-hospital-tanzania
#18
Ramadhani Salum Chambuso, Mkhoi Lord Mkhoi, Evelyn Kaambo
BACKGROUND: Bacterial meningitis is still one of the major causes of deaths, disabilities, and mental retardation in children in Morogoro region. To study the current meningitis burden, we evaluated the common bacterial isolates and clinical outcome of the disease in the region. METHODS: We conducted a hospital-based prospective study on 1352 children aged between 7 days and 12 years admitted in pediatric wards at Morogoro Regional Referral Hospital for 7 months...
July 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28774293/the-clinical-utility-of-the-urine-based-lateral-flow-lipoarabinomannan-assay-in-hiv-infected-adults-in-myanmar-an-observational-study
#19
Swe Swe Thit, Ne Myo Aung, Zaw Win Htet, Mark A Boyd, Htin Aung Saw, Nicholas M Anstey, Tint Tint Kyi, David A Cooper, Mar Mar Kyi, Josh Hanson
BACKGROUND: The use of the point-of-care lateral flow lipoarabinomannan (LF-LAM) test may expedite tuberculosis (TB) diagnosis in HIV-positive patients. However, the test's clinical utility is poorly defined outside sub-Saharan Africa. METHODS: The study enrolled consecutive HIV-positive adults at a tertiary referral hospital in Yangon, Myanmar. On enrolment, patients had a LF-LAM test performed according to the manufacturer's instructions. Clinicians managing the patients were unaware of the LF-LAM result, which was correlated with the patient's clinical course over the ensuing 6 months...
August 4, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28764615/cerebral-tuberculosis-in-a-patient-with-systemic-lupus-erythematosus-following-cyclophosphamide-treatment-a-case-report
#20
S Cooray, H Zhang, R Breen, G Carr-White, R Howard, M Cuadrado, D D'Cruz, G Sanna
Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis...
January 1, 2017: Lupus
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