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meningeal tuberculosis

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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
#1
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/28501491/diagnostic-usefulness-of-xpert-mtb-rif-assay-for-detection-of-tuberculous-meningitis-using-cerebrospinal-fluid
#2
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/28484568/concurrent-multiple-intracranial-and-intramedullary-conus-tuberculoma-a-rare-case-report
#3
Manish Jaiswal, Ashok Gandhi, Devendra Purohit, Radhey Shyam Mittal
Central nervous system (CNS) tuberculosis commonly manifests as tubercular meningitis. CNS tuberculomas are more common intracranially and less frequently involve the spinal cord. Combination of intramedullary with intracranial tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young 16-year-old boy, who presented with two weeks history of paresthesias and weakness of the lower limbs and diminution of vision in left eye, who had been treated for pulmonary tuberculosis...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28482418/-cerebrospinal-fluid-adenosine-deaminase-and-its-dynamic-changes-in-tuberculous-meningitis
#4
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/28480833/nanoemulsion-for-the-effective-treatment-and-management-of-anti-tubercular-drug-therapy
#5
Sarwar Beg, Sumant Saini, Sarim Imam, Mahfoozur Rahman, Suryakanta Swain, M S Hasnain
BACKGROUND: Tuberculosis is considered as one of the deadliest diseases of human existence. Since ancient age the treatment of tuberculosis has been highly challenging primarily owing to the pathogenic nature of the Mycobacterium and its diverse spots of localization in human body including lungs, liver, spleen, eye, meninges and lymph nodes. METHODS: The conventional drug therapy employed for the treatment of tuberculosis is not highly satisfactorily owing to low oral bioavailability of the drugs...
May 3, 2017: Recent Patents on Anti-infective Drug Discovery
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
#6
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
#7
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
#8
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/28462559/granulomatosis-with-polyangiitis-gpa-mimicking-tuberculosis
#9
Vikram Haridas, Kiran Haridas
Granulomatosis with Polyangiitis (GPA) is a rare disease with varied clinical manifestations. We present a case of GPA which manifested initially with symptoms suggestive of meningeal tuberculosis. High index of suspicion and collective review of all clinical features helped in the correct diagnosis. Treatment of this case with rituximab provided significant symptomatic relief.
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28458934/normalization-of-bilateral-adrenal-gland-enlargement-after-treatment-for-cryptococcosis
#10
Yuka Muraoka, Shintaro Iwama, Hiroshi Arima
Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28454648/the-siglec14-null-allele-is-associated-with-mycobacterium-tuberculosis-and-bcg-induced-clinical-and-immunologic-outcomes
#11
Andrew D Graustein, David J Horne, Jerry J Fong, Flavio Schwarz, Heather C Mefford, Glenna J Peterson, Richard D Wells, Munyaradzi Musvosvi, Muki Shey, Willem A Hanekom, Mark Hatherill, Thomas J Scriba, Nguyen Thuy Thuong Thuong, Nguyen Thi Hoang Mai, Maxine Caws, Nguyen Duc Bang, Sarah J Dunstan, Guy E Thwaites, Ajit Varki, Takashi Angata, Thomas R Hawn
Humans exposed to Mycobacterium tuberculosis (Mtb) have variable susceptibility to tuberculosis (TB) and its outcomes. Siglec-5 and Siglec-14 are members of the sialic-acid binding lectin family that regulate immune responses to pathogens through inhibitory (Siglec-5) and activating (Siglec-14) domains. The SIGLEC14 coding sequence is deleted in a high proportion of individuals, placing a SIGLEC5-like gene under the expression of the SIGLEC14 promoter (the SIGLEC14 null allele) and causing expression of a Siglec-5 like protein in monocytes and macrophages...
May 2017: Tuberculosis
https://www.readbyqxmd.com/read/28451090/a-rare-complication-of-pulmonary-tuberculosis-pulmonary-venous-thrombosis-with-atrial-extension
#12
Onkar Balasaheb Auti, Ranganath R, Murali Mohan Bv, Vimal Raj
Pulmonary tuberculosis (TB) is serious public health problem in India and worldwide. The mortality rate in pulmonary TB is high in those with advanced disease and in presence of complications. It presents with wide variety of complications of which haematological complications are rare. Many cases were reported pulmonary TB associated with deep venous thrombosis, hepatic and portal venous thrombosis, central retinal venous thrombosis and sagittal sinus thrombosis in TB meningitis. We report a rare case of pulmonary TB with pulmonary venous thrombosis and atrial extension...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28446486/delayed-diagnosis-of-pulmonary-tuberculosis-in-a-13-year-old-malawian-boy
#13
Niall Johnston, Nichola Sandys
Childhood tuberculosis (TB) is a significant global health burden. There are more than 1 million new cases of childhood TB annually. Despite this, many national TB control programs largely focus on identification and treatment of smear positive adults. Early case detection is essential if childhood TB is to be controlled and eradicated.Delayed diagnosis of TB is associated with more advanced disease and worse treatment outcomes. Younger children who go undiagnosed for long periods are at risk of developing severe pulmonary and extrapulmonary disease, such as meningitis...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28443247/evaluation-of-a-new-ifn-%C3%AE-release-assay-for-rapid-diagnosis-of-active-tuberculosis-in-a-high-incidence-setting
#14
Gen Li, Feng Li, Hui-Min Zhao, Han-Li Wen, Hai-Cong Li, Chun-Ling Li, Ping Ji, Peng Xu, Kang Wu, Zhi-Dong Hu, Shui-Hua Lu, Douglas B Lowrie, Jian-Xin Lv, Xiao-Yong Fan
Blood-based interferon-gamma (IFN-γ) release assays (IGRAs) have been proven to be useful in the diagnosis of Mycobacterium tuberculosis (Mtb) infection. However, IGRAs have not been recommended for clinical practice in most low-income settings due to cost-intensive limitations and shortage of clinical data available. The established T-SPOT. TB assay containing Mtb-specific antigens ESAT-6 and CFP10 are widely used for immunodiagonsis of Mtb infection, but the high cost is one of the restricting factors against its clinical application in the developing countries...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28427163/the-application-of-is6110-baced-loop-mediated-isothermal-amplification-lamp-in-the-early-diagnosis-of-tuberculous-meningitis
#15
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
https://www.readbyqxmd.com/read/28424703/immune-responses-to-bacillus-calmette-gu%C3%A3-rin-vaccination-why-do-they-fail-to-protect-against-mycobacterium-tuberculosis
#16
REVIEW
Juan I Moliva, Joanne Turner, Jordi B Torrelles
Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis (TB), is the current leading cause of death due to a single infectious organism. Although curable, the broad emergence of multi-, extensive-, extreme-, and total-drug resistant strains of M.tb has hindered eradication efforts of this pathogen. Furthermore, computational models predict a quarter of the world's population is infected with M.tb in a latent state, effectively serving as the largest reservoir for any human pathogen with the ability to cause significant morbidity and mortality...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28422850/tuberculosis-associated-hemophagocytic-lymphohistiocytosis-with-initial-presentation-of-fever-of-unknown-origin-in-a-general-hospital-an-analysis-of-8-clinical-cases
#17
Yun Zhang, Guangyu Liang, Hongli Qin, Yuanjie Li, Xuejun Zeng
The study aimed to investigate the clinical features and prognoses of patients with tuberculosis (TB) who had secondary hemophagocytic lymphohistiocytosis (HLH).Patients first presenting with fever of unknown origin, who were ultimately diagnosed with TB-associated secondary HLH, were assessed retrospectively. We summarized and analyzed clinical manifestations, laboratory examinations, diagnoses, treatments, and prognoses of patients using clinical data, outpatient follow-up, and telephone follow-up in combination with literature review...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420846/intrathecal-isoniazid-for-refractory-tuberculous-meningitis-with-cerebral-infarction
#18
Yuko Nakatani, Yutaka Suto, Kazuki Fukuma, Mika Yamawaki, Ryoichi Sakata, Shotaro Takahashi, Hiroyuki Nakayasu, Kenji Nakashima
A 30-year-old Vietnamese woman, about 19 weeks pregnant, was admitted for acute cerebral infarction with stenosis of the left middle cerebral artery (LMCA), tuberculous meningitis, and miliary tuberculosis. Treatment with heparin, quadruple anti-tuberculosis therapy, and dexamethasone afforded prompt symptomatic improvement. However, she delivered a stillbirth, after which there was recurrence of acute cerebral infarction with LMCA occlusion, sinus thrombosis, and cranial base inflammation. A thrice-weekly 100 mg dose of intrathecal isoniazid (INH) improved the signs of meningeal inflammation...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28419368/leukotriene-a4-hydrolase-genotype-and-hiv-infection-influence-intracerebral-inflammation-and-survival-from-tuberculous-meningitis
#19
Nguyen T T Thuong, Dorothee Heemskerk, Trinh T B Tram, Le T P Thao, Lalita Ramakrishnan, Vu T N Ha, Nguyen D Bang, Tran T H Chau, Nguyen H Lan, Maxine Caws, Sarah J Dunstan, Nguyen V V Chau, Marcel Wolbers, Nguyen T H Mai, Guy E Thwaites
Background: Tuberculous meningitis (TBM) is the most devastating form of tuberculosis, yet very little is known about the pathophysiology. We hypothesized that the genotype of leukotriene A4 hydrolase (encoded by LTA4H), which determines inflammatory eicosanoid expression, influences intracerebral inflammation, and predicts survival from TBM. Methods: We characterized the pretreatment clinical and intracerebral inflammatory phenotype and 9-month survival of 764 adults with TBM...
April 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28410692/treatment-outcome-of-extrapulmonary-tuberculosis-under-revised-national-tuberculosis-control-programme
#20
J J Cherian, I Lobo, A Sukhlecha, U Chawan, N A Kshirsagar, B L Nair, L Sawardekar
BACKGROUND: Extrapulmonary tuberculosis (EPTB) constitutes 15-20% of tuberculosis cases in India. Earlier studies have evaluated treatment outcomes of EPTB with little information on outcomes of individual site of EPTB. AIMS: The objective was to study the outcome of Directly Observed Treatment Short course (DOTS) treatment of EPTB in different organ systems under Revised National Tuberculosis Control Programme. METHODS: Multi-centric retrospectives record review was carried out in three states in India...
April 2017: Indian Journal of Tuberculosis
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