8,363 results match your criteria Tuberculous Meningitis


Challenges in the diagnosis of tuberculous meningitis.

J Clin Tuberc Other Mycobact Dis 2020 Aug 11;20:100164. Epub 2020 May 11.

Institute of Human Virology, University of Maryland School of Medicine, 725 W Lombard St, Baltimore, MD 21201, United States.

Tuberculosis (TB) continues to pose a significant public health problem. Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary TB. TBM carries a high mortality rate, including for those receiving treatment for TB. Read More

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http://dx.doi.org/10.1016/j.jctube.2020.100164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240715PMC

Inclusion of Mechanical Ventilation in Severity Staging of Tuberculous Meningitis Improves Outcome Prediction.

Am J Trop Med Hyg 2020 May 26. Epub 2020 May 26.

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Patients with tuberculous meningitis (TBM) in any stage of the British Medical Research Council (BMRC) scale, if requiring mechanical ventilation (MV), are likely to have a poor outcome. We report the usefulness of BMRC, BMRC-MV, and BMRC-hydrocephalus (BMRC-HC) staging, and Haydarpasa Meningitis Severity Index (HAMSI) scoring in predicting the outcome of TBM. One hundred ninety-seven TBM patients were analyzed from a prospective maintained TBM registry. Read More

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http://dx.doi.org/10.4269/ajtmh.20-0077DOI Listing

High Burden of Serious Bacterial Infections in African Children Treated for Cancer.

Pediatr Infect Dis J 2020 May 21. Epub 2020 May 21.

From the Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, Paediatric Oncology Unit, Chris Hani Baragwanath Academic Hospital.

Background: Infections in children treated for cancer contribute to morbidity and mortality. There is a paucity of studies on the incidence, etiology, risk factors and outcome of bacterial infections in African children treated for cancer. The aim of the study was to delineate the epidemiology of infectious morbidity and mortality in children with cancer. Read More

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http://dx.doi.org/10.1097/INF.0000000000002758DOI Listing
May 2020
2.723 Impact Factor

Tuberculous Meningitis Fitting the Shoes of Incomplete Kawasaki Disease.

Indian J Pediatr 2020 May 26. Epub 2020 May 26.

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.

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http://dx.doi.org/10.1007/s12098-020-03339-3DOI Listing

Tuberculous otitis media in children: Series of 4 cases.

Int J Pediatr Otorhinolaryngol 2020 May 13;135:110118. Epub 2020 May 13.

Department of ENT and Head & Neck Surgery, St Stephen's Hospital, Delhi, India. Electronic address:

Four cases of tuberculous otitis media in children are reported. One case presented with a postaural fistula, another case with signs of meningeal irritation and ear discharge and two cases as chronic otitis media refractory to conventional treatment. All patients underwent modified radical mastoidectomy and the diagnosis was made postoperativelyby histopathology in three cases and Ziehl-Neelson stainig of the discharge from the mastoid cavity in one. Read More

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http://dx.doi.org/10.1016/j.ijporl.2020.110118DOI Listing

Extra-central nervous system tuberculosis in HIV-uninfected patients of tuberculous meningitis: A prospective evaluation.

J Infect Public Health 2020 May 18. Epub 2020 May 18.

Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, 226003, India.

Objective: Disseminated tuberculosis is characterized with involvement of two or more non-contiguous sites. In this work we evaluated patients of tuberculous meningitis for possible extra-central nervous system tuberculosis.

Method: This prospective observational study was performed at a tertiary care institute in Northern India. Read More

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http://dx.doi.org/10.1016/j.jiph.2020.04.011DOI Listing

Magnetic bead flocculation test: Improving the diagnosis of tuberculous meningitis (TBM) in low-resource settings.

Mol Cell Probes 2020 May 10:101595. Epub 2020 May 10.

Department of Microbiology, India.

Background: Despite several recent advances in detection techniques, there is still an unmet need for simple tests for the diagnosis of tuberculous meningitis (TBM). Therefore, in an effort towards developing a simple and rapid diagnostic test for resource-poor settings, we designed an assay in which magnetic bead flocculation test (MBF) was used to detect the amplified DNA. Multi-targeted (using two multicopy gene targets IS6110 and IS1081) loop-mediated isothermal amplification (MLAMP) was used for amplification. Read More

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http://dx.doi.org/10.1016/j.mcp.2020.101595DOI Listing

Clofazimine enhances the efficacy of BCG revaccination via stem cell-like memory T cells.

PLoS Pathog 2020 May 21;16(5):e1008356. Epub 2020 May 21.

Special Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, India.

Tuberculosis (TB) is one of the deadliest diseases, claiming ~2 million deaths annually worldwide. The majority of people in TB endemic regions are vaccinated with Bacillus Calmette Guerin (BCG), which is the only usable vaccine available. BCG is efficacious against meningeal and disseminated TB in children, but protective responses are relatively short-lived and fail to protect against adult pulmonary TB. Read More

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http://dx.doi.org/10.1371/journal.ppat.1008356DOI Listing

Determination of cerebrospinal fluid adenosine deaminase activity cut-off for the diagnosis of tuberculous meningitis in Hong Kong.

J Clin Pathol 2020 May 18. Epub 2020 May 18.

Chemical Pathology Laboratory, Department of Pathology, Princess Margaret Hospital, Kowloon, Hong Kong.

Aims: Tuberculous meningitis (TBM) is a severe infection which may lead to serious complication and mortality. Prompt diagnosis and treatment are essential. There is a need for a simple and fast laboratory test to differentiate TBM from other causes. Read More

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http://dx.doi.org/10.1136/jclinpath-2019-206397DOI Listing

Tuberculous meningitis presenting with nonconvulsive status epilepticus and transient diffusion restriction: A rare case.

Neurol India 2020 Mar-Apr;68(2):512-514

Department of Neurology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, Japan.

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http://dx.doi.org/10.4103/0028-3886.283759DOI Listing

Derivation of a bedside score (MASH-P) to predict 6-month mortality in tuberculous meningitis.

J Neurol Sci 2020 May 5;415:116877. Epub 2020 May 5.

Department of Neurology, King George's Medical University, U.P, Lucknow 226003, India. Electronic address:

Background: Tuberculous meningitis is commonly associated with a poor outcome. Simple bedside prognostic scores can help immensely in predicting the outcome.

Materials And Method: A total of 721 patients, from 5 of our previous studies, were included. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116877DOI Listing

Standardized approaches for clinical sampling and endpoint ascertainment in tuberculous meningitis studies.

Wellcome Open Res 2019 16;4:204. Epub 2019 Dec 16.

Department of Internal Medicine and Radboud Center of Infectious Diseases (RCI), Radboud University Medical Center, Nijmegen, The Netherlands.

Tuberculous meningitis (TBM), the most severe manifestation of tuberculosis, has poorly understood immunopathology and high mortality and morbidity despite antituberculous therapy. This calls for accelerated clinical and basic science research in this field. As TBM disproportionally affects poorer communities, studies are often performed in resource-limited environments, creating challenges for data collection and harmonisation. Read More

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http://dx.doi.org/10.12688/wellcomeopenres.15497.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194504PMC
December 2019

Overview of Brain-to-Gut Axis Exposed to Chronic CNS Bacterial Infection(s) and a Predictive Urinary Metabolic Profile of a Brain Infected by .

Front Neurosci 2020 21;14:296. Epub 2020 Apr 21.

Human Metabolomics, Faculty of Natural and Agricultural Sciences, North-West University, Potchefstroom, South Africa.

A new paradigm in neuroscience has recently emerged - the brain-gut axis (BGA). The contemporary focus in this paradigm has been gut → brain ("bottom-up"), in which the gut-microbiome, and its perturbations, affects one's psychological state-of-mind and behavior, and is pivotal in neurodegenerative disorders. The emerging brain → gut ("top-down") concept, the subject of this review, proposes that dysfunctional brain health can alter the gut-microbiome. Read More

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http://dx.doi.org/10.3389/fnins.2020.00296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186443PMC

Real-time polymerase chain reaction for Mycobacterium tuberculosis meningitis is more sensitive in patients with HIV co-infection.

Curr HIV Res 2020 May 4. Epub 2020 May 4.

Bacteriology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná. Brazil.

Background: Tuberculous meningitis (TbM) is the most severe complication of extrapulmonary tuberculosis (Tb). There is higher frequency of positive cerebrospinal fluid (CSF) cultures for Mycobacterium tuberculosis (MTb) in samples from human immunodeficiency virus (HIV) co-infected patients than in those from HIV-negative patients. We hypothesized that real time PCR assays for MTb (MTb qPCR) using CSF would be more sensitive in HIV co-infected patients owing to a greater MTb burden. Read More

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http://dx.doi.org/10.2174/1570162X18666200505083728DOI Listing

Management of intracranial tuberculous mass lesions: how long should we treat for?

Wellcome Open Res 2019 31;4:158. Epub 2019 Oct 31.

Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Medicine, University of Cape Town, Cape Town, 7925, South Africa.

Tuberculous intracranial mass lesions are common in settings with high tuberculosis (TB) incidence and HIV prevalence. The diagnosis of such lesions, which include tuberculoma and tuberculous abscesses, is often presumptive and based on radiological features, supportive evidence of TB elsewhere and response to TB treatment. However, the treatment response is unpredictable, with lesions frequently enlarging paradoxically or persisting for many years despite appropriate TB treatment and corticosteroid therapy. Read More

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http://dx.doi.org/10.12688/wellcomeopenres.15501.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996525.2PMC
October 2019

Epidemiological, clinical characteristics and drug resistance situation of culture-confirmed children TBM in southwest of China: a 6-year retrospective study.

BMC Infect Dis 2020 May 1;20(1):318. Epub 2020 May 1.

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.

Background: Sichuan is a province located in southwestern China, which have a higher incidence of tuberculosis (TB). This study aimed to analyze the epidemiological and clinical characteristics, as well as drug resistance in culture-confirmed children with Tuberculosis meningitis (TBM) in Southwest of China.

Methods: We performed a retrospective study on children (< 14 years old) with cerebrospinal fluid (CSF) culture-confirmed TBM between January 2013 and December 2018 at Public Health Clinical Center of Chengdu (PHCCC). Read More

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http://dx.doi.org/10.1186/s12879-020-05041-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195785PMC

Metagenomic Next-Generation Sequencing (mNGS) in cerebrospinal fluid for rapid diagnosis of Tuberculosis meningitis in HIV-negative population.

Int J Infect Dis 2020 Apr 24;96:270-275. Epub 2020 Apr 24.

Clinic and Research Center of Tuberculosis, Department of Tuberculosis, Shanghai Key Laboratory of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. Electronic address:

Objective: Metagenomic Next-Generation Sequencing (mNGS) has been applied as a novel method of detection pathogens for infectious diseases, but its value in the rapid diagnosis of tuberculous meningitis(TBM)has not been clarified based on large samples.

Methods: A retrospective analysis was conducted on 51 inpatients with suspected TBM who underwent mNGS and four other tests in cerebrospinal fluid (CSF).

Results: Among 51 included patients, 45 cases were diagnosed as TBM (38 definite, 5 probable, 2 possible) and 6 cases as non-TBM. Read More

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http://dx.doi.org/10.1016/j.ijid.2020.04.048DOI Listing

CNS infections in HIV.

Authors:
Kiran T Thakur

Curr Opin Infect Dis 2020 Jun;33(3):267-272

Winifred Mercer Pitkin Assistant Professor of Neurology, Division of Critical Care and Hospitalist Neurology, Department of Neurology, Columbia University Irving Medical Center and New York Presbyterian, New York, USA.

Purpose Of Review: Central nervous system (CNS) infections associated with HIV remain significant contributors to morbidity and mortality, particularly among people living with HIV (PLWH) in resource-limited settings worldwide. In this review, we discuss several recent important scientific discoveries in the prevention, diagnosis, and management around two of the major causes of CNS opportunistic infections-tuberculous meningitis (TBM) and cryptococcal meningitis including immune reconstitution syndrome (IRIS) associated with cryptococcal meningitis. We also discuss the CNS as a possible viral reservoir, highlighting Cerebrospinal fluid viral escape. Read More

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http://dx.doi.org/10.1097/QCO.0000000000000652DOI Listing

Acute Stroke in Tubercular Meningitis: A Case Report.

JNMA J Nepal Med Assoc 2019 Sep-Oct;57(219):385-387

Manipal College of Medical Sciences, Pokhara, Nepal.

Most of the strokes in tubercular meningitis are multiple, bilateral, and located in the basal ganglia, especially the 'tubercular zone', which comprises of the caudate, anterior thalamus, anterior limb, and genu of the internal capsule. These are attributed to the involvement of medial striate, thalamotuberal, and thalamostriate arteries, which are embedded in exudates and likely to be stretched by coexistent hydrocephalus. Corticosteroids with antitubercular therapy were thought to reduce mortality and morbidity but their role in lowering strokes has not been proven. Read More

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Tuberculous meningitis: where to from here?

Curr Opin Infect Dis 2020 Jun;33(3):259-266

Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam.

Purpose Of Review: Tuberculous meningitis (TBM) is associated with significant mortality and morbidity yet is difficult to diagnose and treat. We reviewed original research published in the last 2 years, since 1 January 2018, which we considered to have a major impact in advancing diagnosis, treatment and understanding of the pathophysiology of TBM meningitis in children and adults.

Recent Findings: Studies have sought to identify a high sensitivity diagnostic test for TBM, with new data on modified Ziehl--Neelsen staining, urinary and cerebrospinal fluid (CSF) lipoarabinomannan and GeneXpert Ultra. Read More

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http://dx.doi.org/10.1097/QCO.0000000000000648DOI Listing

A Complete Triad: Horner's Syndrome in Tuberculous Meningitis.

Am J Med Sci 2020 Apr 5. Epub 2020 Apr 5.

Department of Internal Medicine, McMaster University, Hamilton, Canada.

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http://dx.doi.org/10.1016/j.amjms.2020.03.017DOI Listing
April 2020
1.515 Impact Factor

Diagnostic Challenges and Dilemmas in Tuberculous Meningitis.

Am J Med Sci 2020 Mar 13. Epub 2020 Mar 13.

Department of Medicine, University of Minnesota, Minneapolis, Minnesota. Electronic address:

Tuberculosis is a global burden with an unacceptably high mortality rate, especially in low- and middle-income countries. We reported the case of 34-year-old Somali female with no significant risk factors who initially presented with headache and blurred vision. The patient subsequently developed altered mental status and significant vision changes. Read More

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http://dx.doi.org/10.1016/j.amjms.2020.03.010DOI Listing

Oxidative stress and ER stress may contribute to drug-induced hepatitis in tuberculous meningitis.

J Neurol Sci 2020 Apr 11;414:116825. Epub 2020 Apr 11.

Department of Biostatistics & Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Background: Study of oxidative stress and endoplasmic reticulum (ER) stress markers in drug induced hepatitis (DIH) associated with tuberculous meningitis (TBM) has not been done. Such a study may provide information on the role of stress in DIH.

Objective: To report the role of oxidative stress and ER stress in DIH associated with TBM and their effect on outcome of patients. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116825DOI Listing

Ventriculoperitoneal shunt insertion in human immunodeficiency virus infected adults: a systematic review and meta-analysis.

BMC Neurol 2020 Apr 17;20(1):141. Epub 2020 Apr 17.

Division of Neurosurgery, University of Cape Town, H53 Old Main Building, Groote Schuur Hospital, Main Road, Observatory, Cape Town, 7925, South Africa.

Background: Hydrocephalus is a common, life threatening complication of human immunodeficiency virus (HIV)-related central nervous system opportunistic infection which can be treated by insertion of a ventriculoperitoneal shunt (VPS). In HIV-infected patients there is concern that VPS might be associated with unacceptably high mortality. To identify prognostic indicators, we aimed to compare survival and clinical outcome following VPS placement between all studied causes of hydrocephalus in HIV infected patients. Read More

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http://dx.doi.org/10.1186/s12883-020-01713-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164262PMC

Performance of immune-based and microbiological tests in children with TB meningitis in Europe - a multi-center Paediatric Tuberculosis Network European Trials Group (ptbnet) study.

Eur Respir J 2020 Apr 16. Epub 2020 Apr 16.

Department of Paediatric Infectious Diseases & Immunology, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK

Introduction: Tuberculous meningitis (TBM) is often diagnostically challenging. Only limited data exist on the performance of interferon-gamma release assays (IGRA) and molecular assays in children with TBM in routine clinical practice, particularly in the European setting.

Methods: Multicenter, retrospective study involving 27 healthcare institutions providing care for children with tuberculosis (TB) in nine European countries. Read More

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http://dx.doi.org/10.1183/13993003.02004-2019DOI Listing

Multiple Intracranial Tuberculomas with an Intra-medullary Spinal Cord Tuberculoma in a Pediatric Patient.

Cureus 2020 Mar 12;12(3):e7248. Epub 2020 Mar 12.

Internal Medicine, The University of Texas Health Science Center/Christus Good Shepherd Medical Center, Longview, USA.

Central nervous system (CNS) tuberculosis (TB), caused by Mycobacterium tuberculosis (MT), is a severe form of TB, which presents as meningitis, cerebritis, abscesses, spinal tuberculous arachnoiditis, and rarely tuberculomas. CNS TB is prevalent in the underdeveloped or developing world and is common in malnourished, alcoholics, children, young adults, immunocompromised, and cancer patients. Intracranial tuberculomas (ICT) can present with symptoms and signs of focal neurological deficits with or without systemic manifestations. Read More

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http://dx.doi.org/10.7759/cureus.7248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152571PMC

Methods for rapid diagnosis of meningitis etiology in adults.

Biomark Med 2020 Apr 9;14(6):459-479. Epub 2020 Apr 9.

Division of Infectious Diseases, Department of Medicine, University of Kansas, Kansas City, KS 66160, USA.

Infectious meningitis can be caused by viral, bacterial or fungal pathogens. Despite widely available treatments, many types of infectious meningitis are still associated with significant morbidity and mortality. Delay in diagnosis contributes to poor outcomes. Read More

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http://dx.doi.org/10.2217/bmm-2019-0333DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248681PMC

Neurological symptoms of familial hemophagocytic lymphohistiocytosis type 2.

J Integr Neurosci 2020 Mar;19(1):131-135

Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, P. R. China.

Hemophagocytic lymphohistiocytosis with central nervous system involvement is caused by inflammatory factor storms. The inflammatory factors invade the blood-brain barrier and further infiltrate brain tissue resulting in associated neurological and/or psychiatric symptoms in hemophagocytic lymphohistiocytosis with central nervous system involvement patients. This case report is based on a 14-year-old male patient who experienced intermittent dizziness and blurred vision about five years before admission as well as lower limb weakness and unstable walking approximately three years before admission. Read More

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http://dx.doi.org/10.31083/j.jin.2020.01.1250DOI Listing

Infections causing stroke or stroke-like syndromes.

Infection 2020 Jun 1;48(3):323-332. Epub 2020 Apr 1.

Department of Infectious Diseases, University of Salerno, Salerno, Italy.

Background: Stroke has relevant morbidity and mortality despite appropriate treatments and early diagnosis. Beside common risk factors such as diabetes and atrial fibrillation, infections can be involved in stroke pathogenesis, probably causing a systemic release of cytokines and other inflammatory mediators, triggering a latent pro-thrombotic state or damaging the vascular endothelium. In other cases, infections can occur as stroke-like syndromes, requiring a high grade of suspicion to avoid a delay in establishing a correct diagnosis. Read More

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http://dx.doi.org/10.1007/s15010-020-01415-6DOI Listing

Infection-Associated Opsoclonus: A Retrospective Case Record Analysis and Review of Literature.

J Child Neurol 2020 Jun 27;35(7):480-484. Epub 2020 Mar 27.

Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Opsoclonus, an uncommon clinical sign, and is often described in the context of opsoclonus myoclonus ataxia syndrome (OMAS). OMAS may be paraneoplastic or postinfectious. However, opsoclonus with or without OMAS may occur in association with a wide gamut of infections. Read More

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http://dx.doi.org/10.1177/0883073820911327DOI Listing
June 2020
1.666 Impact Factor

Metagenomic Next-Generation Sequencing for Diagnosis of Infectious Encephalitis and Meningitis: A Large, Prospective Case Series of 213 Patients.

Front Cell Infect Microbiol 2020 5;10:88. Epub 2020 Mar 5.

Department of Neurology, First Medical Center of PLA General Hospital, Beijing, China.

We assessed the performance of metagenomic next-generation sequencing (mNGS) in the diagnosis of infectious encephalitis and meningitis. This was a prospective multicenter study. Cerebrospinal fluid samples from patients with viral encephalitis and/or meningitis, tuberculous meningitis, bacterial meningitis, fungal meningitis, and non-central nervous system (CNS) infections were subjected to mNGS. Read More

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http://dx.doi.org/10.3389/fcimb.2020.00088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066979PMC

An improved protocol to establish experimental tuberculous meningitis in the rabbit.

MethodsX 2020 21;7:100832. Epub 2020 Feb 21.

Public Health Research Institute of New Jersey Medical School, United States.

Tuberculous meningitis (TBM), caused by (Mtb), is the deadliest form of tuberculosis in humans, particularly in children and the geriatric population. However, the host-pathogen interactions underlying TBM is not well understood. Rabbits are a valuable model system to study TB in humans. Read More

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http://dx.doi.org/10.1016/j.mex.2020.100832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078415PMC
February 2020

Tuberculous meningitis: An unlikely cause of Guillain-Barre syndrome.

Indian J Tuberc 2020 Jan 7;67(1):139-142. Epub 2020 Jan 7.

Department of Medicine, VMMC & Safdarjung Hospital, Delhi, India.

Guillain-Barre syndrome (GBS) is a life-threatening immune-mediated acute inflammatory polyneuropathy and is associated with various antecedent infections. Its association with tuberculosis is very uncommon with only a handful of cases being reported in the literature. It's association with tuberculous meningitis is even more scarce with only one case reported in literature till date. Read More

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http://dx.doi.org/10.1016/j.ijtb.2019.12.002DOI Listing
January 2020

Tuberculous meningitis manifesting with neuroregression in a eleven month child.

Indian J Tuberc 2020 Jan 8;67(1):136-138. Epub 2020 Jan 8.

Department of Pediatrics, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth University, Pillayarkuppam, Puducherry, 607402, India.

Tuberculosis (TB) is a disease of diverse manifestations. In children, neurotuberculosis is the severest form, which when left untreated can have deleterious consequences. There has been reports on pediatric TB meningitis manifesting with fever and seizures, altered sensorium or focal deficits. Read More

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http://dx.doi.org/10.1016/j.ijtb.2020.01.001DOI Listing
January 2020

Tracking down the White Plague: The skeletal evidence of tuberculous meningitis in the Robert J. Terry Anatomical Skeletal Collection.

PLoS One 2020 18;15(3):e0230418. Epub 2020 Mar 18.

Institut für Anatomie und Embryologie, Zentrum Anatomie, Universitätsmedizin Göttingen, Göttingen, Germany.

Paleopathological diagnosis of tuberculosis (TB) essentially relies on the identification of macroscopic lesions in the skeleton that can be related to different manifestations of TB. Among these alterations, granular impressions (GIs) on the inner skull surface have been considered as pathognomonic features of tuberculous meningitis (TBM). GIs may be established by pressure atrophy of the tubercles formed on the outermost meningeal layer during later stages of TBM. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0230418PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080279PMC

Clinical, Imaging, and Laboratory Characteristics of Adult Mexican Patients with Tuberculous Meningitis: A Retrospective Cohort Study.

J Epidemiol Glob Health 2020 Mar;10(1):59-64

Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.

Tuberculous Meningitis (TBM) is the most common form of central nervous system Tuberculosis (TB), accounting for 5-6% of extrapulmonary TB cases. Nowadays, TBM continues to be a major topic in public health because of its high prevalence worldwide. This retrospective study aimed to describe the clinical, laboratory, and imaging characteristics at admission; and in-hospital outcome of adult Mexican patients with TBM. Read More

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http://dx.doi.org/10.2991/jegh.k.191023.001DOI Listing

First case report of tuberculous meningitis secondary to endometrial tuberculosis following a clandestine abortion.

Infez Med 2020 Mar;28(1):82-86

Department of Clinical Pathology, Hospital Regional Lambayeque, Chiclayo, Peru.

Tuberculous meningitis (TBM) is a medical emergency: it is the most severe, lethal and disabling clinical form of tuberculosis. We report the case of a 44-year-old woman who had undergone a clandestine abortion six weeks before admission. One week later, she had abnormal vaginal discharge. Read More

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Longitudinal cerebrospinal fluid assessment in a patient with tuberculous meningitis-A case report.

J Clin Lab Anal 2020 Mar 11:e23286. Epub 2020 Mar 11.

Department of Laboratory Medicine, Chest Hospital of Hebei Province, Shijiazhuang, China.

Background: Dynamic assessment of cerebrospinal fluid (CSF) is essential for diagnosis, treatment, and prognosis of tuberculous meningitis, one of the most severe forms of central nervous system (CNS) infection.

Case Presentation: A 45-year-old man sought care as he developed confusion, clonic convulsion, and coma. Longitudinal, comprehensive analyses of cytological, biochemical, and microbial changes in CSF specimen were assessed for this patient. Read More

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http://dx.doi.org/10.1002/jcla.23286DOI Listing

Author‑Based versus Group‑Based Systemic Reviews and Meta‑Analysis.

Authors:
Sunil K Raina

Neurol India 2020 Jan-Feb;68(1):204-205

Department of Community Medicine, DR. RPGMC, Tanda, Kangra, Himachal Pradesh, India.

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http://dx.doi.org/10.4103/0028-3886.279699DOI Listing

Knowledge gaps and research priorities in tuberculous meningitis.

Wellcome Open Res 2019 28;4:188. Epub 2019 Nov 28.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), accounting for around 1-5% of the global TB caseload, with mortality of approximately 20% in children and up to 60% in persons co-infected with human immunodeficiency virus even in those treated. Relatively few centres of excellence in TBM research exist and the field would therefore benefit from greater co-ordination, advocacy, collaboration and early data sharing. To this end, in 2009, 2015 and 2019 we convened the TBM International Research Consortium, bringing together approximately 50 researchers from five continents. Read More

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http://dx.doi.org/10.12688/wellcomeopenres.15573.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7014926PMC
November 2019

Establishing the cascade of care for patients with tuberculous meningitis.

Wellcome Open Res 2019 13;4:177. Epub 2019 Nov 13.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Meningitis is a relatively rare form of tuberculosis, but it carries a high mortality rate, reaching 50% in some settings, with higher rates among patients with HIV co-infection and those with drug-resistant disease. Most studies of tuberculosis meningitis (TBM) tend to focus on better diagnosis, drug treatment and supportive care for patients in hospital. However, there is significant variability in mortality between settings, which may be due to specific variation in the availability and quality of health care services, both prior to, during, and after hospitalization. Read More

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http://dx.doi.org/10.12688/wellcomeopenres.15515.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008603PMC
November 2019

The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes.

Wellcome Open Res 2019 5;4:167. Epub 2019 Nov 5.

Department of Infectious Diseases, University of Kansas, Kansas City, KS, USA.

Tuberculous meningitis (TBM) results from dissemination of to the cerebrospinal fluid (CSF) and meninges. Ischaemia, hydrocephalus and raised intracranial pressure frequently result, leading to extensive brain injury and neurodisability. The global burden of TBM is unclear and it is likely that many cases are undiagnosed, with many treated cases unreported. Read More

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http://dx.doi.org/10.12688/wellcomeopenres.15535.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7029758PMC
November 2019

Platelet dysfunction and coagulation assessment in patients of tuberculous meningitis.

Neurol Sci 2020 Feb 29. Epub 2020 Feb 29.

Department of Neurology, KGMU, Lucknow, King George's Medical University, Lucknow, 226003, India.

Introduction: Tuberculous meningitis (TBM) is the most severe form of tuberculosis. As reported in various studies, stroke is common among patients with TBM, with a prevalence of 17-54%. The present study assessed platelet dysfunction and coagulation abnormality in patients with TBM. Read More

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http://dx.doi.org/10.1007/s10072-020-04299-4DOI Listing
February 2020

[Case of isolated neurosarcoidosis requiring differentiation from tuberculous meningitis].

Rinsho Shinkeigaku 2020 Mar 26;60(3):213-218. Epub 2020 Feb 26.

Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center.

A 62-year-old woman was transported to our hospital for management of generalized clonic seizures. Cerebrospinal fluid examination showed an increased monocyte-dominant cell count, high protein concentration, and low glucose concentration that was 17% of the plasma glucose concentration. Contrast-enhanced cranial magnetic resonance imaging revealed diffuse leptomeningeal enhancement with multiple nodular lesions. Read More

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http://dx.doi.org/10.5692/clinicalneurol.cn-001387DOI Listing

Outbreak of Beijing Strain in a High School in Yunnan, China.

Am J Trop Med Hyg 2020 Apr;102(4):728-730

Yunnan Provincial Center for Disease Control and Prevention, Kunming, China.

In this study, we report an investigation of a tuberculosis (TB) outbreak in a high school in China. Eleven students with active TB were identified. A culture-negative 17-year-old girl was considered as index case affected by pulmonary and meningeal TB. Read More

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http://dx.doi.org/10.4269/ajtmh.19-0533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7124909PMC
April 2020
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Differentiation of Intraspinal Tuberculosis and Metastatic Cancer Using Magnetic Resonance Imaging.

Infect Drug Resist 2020 4;13:341-349. Epub 2020 Feb 4.

Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.

Purpose: This study aimed to explore the differences in the magnetic resonance imaging (MRI) findings between intraspinal tuberculosis and metastatic cancer, which may aid in making the correct diagnosis.

Patients And Methods: The clinical features and MRI findings of 15 patients with intraspinal tuberculosis and 11 patients with intraspinal metastatic cancers were retrospectively analyzed.

Results: The mean ages of the patients with intraspinal tuberculosis and metastatic cancer were 26. Read More

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http://dx.doi.org/10.2147/IDR.S224238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7007797PMC
February 2020

New-onset seizures in adults with tuberculous meningitis during long-term follow-up: Characteristics, functional outcomes and risk factors.

Int J Infect Dis 2020 Apr 13;93:258-263. Epub 2020 Feb 13.

Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China. Electronic address:

Objective: This study aimed to determine the characteristics and risk factors of adult new-onset seizure patients with tuberculous meningitis (TBM) during long-term follow-up.

Methods: Patients with TBM who were seen between June 2012 and January 2018 were retrospectively reviewed and categorized into two groups based on the presence or absence of new-onset seizures. Seizure characteristics, functional outcomes and risk factors were assessed. Read More

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http://dx.doi.org/10.1016/j.ijid.2020.02.007DOI Listing

Central nervous system tuberculoma with miliary tuberculosis in the elderly.

IDCases 2020 29;19:e00710. Epub 2020 Jan 29.

Department of Neurology, International University of Health and Welfare Hospital, 537-3, Iguchi, Nasushiobara, Tochigi, 329-2763, Japan.

The aging phenomenon of tuberculosis (TB) patients is recognized all over the world, but no country is as prominent as Japan. Central nervous system (CNS) TB includes clinical entities: tuberculous meningitis, intracranial tuberculoma, and clinical features of CNS TB in the elderly may be atypical, non-specific, and confused with concomitant age-related diseases. Atypical clinical manifestations of TB in older persons can result in delay in diagnosis and initiation of treatment. Read More

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http://dx.doi.org/10.1016/j.idcr.2020.e00710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005458PMC
January 2020

An unusual presentation of gross cerebral vascular dilatation in a TB/HIV co-infected individual.

Br J Neurosurg 2020 Feb 8:1-4. Epub 2020 Feb 8.

Department of Neurosurgery, Tygerberg Hospital, Cape Town, South Africa.

Aneurysmal dilatation secondary to HIV vasculitis is well described being more common in patients under 45 years of age with advanced stage HIV infection (CD4 < 200 cells/µl). Tuberculous meningitis is far more common than previously anticipated with centres in Cape Town publishing that more than half of all cases of adult meningitis were secondary to tuberculosis. But aneurysmal dilatation of the cerebral vessels is exceedingly rare complication in this population. Read More

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http://dx.doi.org/10.1080/02688697.2020.1725439DOI Listing
February 2020

Medical management of acute loss of vision in tuberculous meningitis: A case report.

J Clin Tuberc Other Mycobact Dis 2020 May 18;19:100145. Epub 2020 Jan 18.

Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

Blindness and vision impairment are unpredictable complications of tuberculous meningitis (TBM) that are often unrecognized in the acute stages of illness due to inability to assess vision in patients with depressed levels of consciousness or confusion. We present a patient with definite TBM confirmed by positive Xpert MTB/RIF assay of cerebrospinal fluid (CSF) who developed binocular blindness two weeks after diagnosis and initiation of standard anti-tuberculosis treatment (ATT). Ophthalmological exam demonstrated complete bilateral abducens nerve palsies, impaired pupillary responses to light, normal optic discs, and visual acuity of hand motion only in each eye. Read More

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http://dx.doi.org/10.1016/j.jctube.2020.100145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992978PMC