8,574 results match your criteria Tuberculous Meningitis


Cerebral Venous Sinus Thrombosis in Children: A Study from a Tertiary Care Hospital of Eastern India.

J Pediatr Neurosci 2020 Oct-Dec;15(4):370-374. Epub 2021 Jan 19.

Department of Neurology, Srirama Chandra Bhanja Medical College & Hospital (SCBMCH), Cuttack, Odisha, India.

Context: Cerebral venous sinus (sinovenous) thrombosis (CVST) in childhood is a rare, but under recognized, disorder, typically of multifactorial etiology, with neurologic sequelae apparent in up to 40% of survivors and mortality approaching 10%.

Aim: The aim of this study was to enlist the patients diagnosed as CVST younger than 14 years of age and to diagnose the etiology along with radiological correlation.

Settings And Design: This prospective clinical study was conducted for 2 years in the Department of Neurology, Srirama Chandra Bhanja Medical College & Hospital (SCBMCH), Cuttack, Odisha, India. Read More

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January 2021

Serum and cerebrospinal fluid host proteins indicate stroke in children with tuberculous meningitis.

PLoS One 2021 30;16(4):e0250944. Epub 2021 Apr 30.

Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Introduction: Stroke is a common complication in children with tuberculous meningitis (TBM). Host proteins may give us insight into the mechanisms of stroke in TBM and serve as biomarkers for detection of stroke, however, they have not been widely explored. In this study, we compared the concentrations of cerebrospinal fluid (CSF) and serum proteins between children who had TBM-related stroke and children with TBM without stroke. Read More

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Defeating Paediatric Tuberculous Meningitis: Applying the WHO "Defeating Meningitis by 2030: Global Roadmap".

Microorganisms 2021 Apr 16;9(4). Epub 2021 Apr 16.

MRC Clinical Trials Unit at UCL, 90 High Holborn, Holborn, London WC1V 6LJ, UK.

Children affected by tuberculous meningitis (TBM), as well as their families, have needs that lie at the intersections between the tuberculosis and meningitis clinical, research, and policy spheres. There is therefore a substantial risk that these needs are not fully met by either programme. In this narrative review article, we use the World Health Organization (WHO) "Defeating Meningitis by 2030: global roadmap" as a starting point to consider key goals and activities to specifically defeat TBM in children. Read More

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The Impact and Burden of Neurological Sequelae Following Bacterial Meningitis: A Narrative Review.

Microorganisms 2021 Apr 22;9(5). Epub 2021 Apr 22.

Brain Health Unit, Department of Mental Health and Substance Use, World Health Organization (WHO), 1202 Geneva, Switzerland.

The burden, impact, and social and economic costs of neurological sequelae following meningitis can be devastating to patients, families and communities. An acute inflammation of the brain and spinal cord, meningitis results in high mortality rates, with over 2.5 million new cases of bacterial meningitis and over 236,000 deaths worldwide in 2019 alone. Read More

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Comparative analysis between tuberculous meningitis and other forms of extrapulmonary tuberculosis.

Germs 2021 Mar 15;11(1):23-31. Epub 2021 Mar 15.

MD, Infectious Diseases Department and Extra-pulmonary Research Unity, Hedi Chaker University Hospital, University of Sfax, 3029, Tunisia.

Introduction: Tuberculosis is a multisystem disease that may affect any organ or tissue. Tuberculous meningitis (TBM) is the most severe form of tuberculosis and commonly affects the brain. We aimed to study the epidemiological, clinical, therapeutic and evolutionary features of TBM among adults and to compare them with other forms of extrapulmonary tuberculosis. Read More

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Recurrent tuberculous cerebellar abscess: A case study and review of the literature.

Int J Surg Case Rep 2021 Apr 26;81:105832. Epub 2021 Mar 26.

Neurosurgery Department, Fann University Hospital Center, Dakar, Senegal.

Introduction And Importance: Tuberculous cerebellar abscess is a rare form of extra-pulmonary tuberculosis. The outcome is often favorable with well-managed treatment; however, they can continue to develop. We share in this article our experience on the management of this rare pathologie. Read More

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Risk factors for poor outcome in childhood tuberculous meningitis.

Sci Rep 2021 Apr 21;11(1):8654. Epub 2021 Apr 21.

Department of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107#, Wenhuaxi Road, Jinan, 250012, Shandong, China.

Tuberculous meningitis (TBM) remains a serious disease for children and its risk factors of poor outcome remain unclear. Therefore, a retrospective study was conducted aiming to investigate the risk factors associated with poor outcome of childhood TBM. Between January 2006 and December 2019, consecutive children patients (≤ 15 years old) who had a diagnosis of TBM were included for the analysis. Read More

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Tuberculous meningitis: When should we consider depletive lumbar punctures?

Infect Dis Now 2021 Jan 28. Epub 2021 Jan 28.

Service de neurologie, centre hospitalier de Saint-Denis, Saint-Denis, France. Electronic address:

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January 2021

Frequency of Hyponatremia in Patients of Tuberculosis Bacterial Meningitis in a Tertiary Care Hospital.

Cureus 2021 Mar 14;13(3):e13888. Epub 2021 Mar 14.

Department of Neurology, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Introduction Tuberculous meningitis (TBM) brings significant morbidity and mortality worldwide. Hyponatremia has long been documented as a potentially grave metabolic result of TBM. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has been supposed to be accountable for the majority of cases of hyponatremia in TBM. Read More

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Management of syringomyelia associated with tuberculous meningitis: A case report and systematic review of the literature.

J Clin Neurosci 2021 May 5;87:20-25. Epub 2021 Mar 5.

Division of Neurosciences Critical Care, Department of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address:

Determinants of tuberculosis (TB) syringomyelia, its management options and outcomes are still under investigation. The aim of this study is to present a case of TB syringomyelia with markedly improved symptoms status-post surgery and to understand the clinical characteristics and outcomes of 33 TB syringomyelia cases reported in the literature. Specifically, we examined the differences between patients who were managed medically and those who underwent surgical intervention. Read More

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Risk factors for ischemic stroke in children with tuberculous meningitis.

Childs Nerv Syst 2021 Apr 15. Epub 2021 Apr 15.

Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Purpose: Cerebrovascular complications are commonly observed in children with tuberculous meningitis. We aimed to determine which clinical factors were associated with stroke at admission in children with tuberculous meningitis and, in children stroke-free at admission, which factors were associated with development of stroke on treatment.

Methods: We analysed a cohort of 474 children diagnosed with 'definite' and 'probable' tuberculous meningitis, with prospectively collected data, at Tygerberg Hospital, Cape Town, South Africa from 1985 to 2005. Read More

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Outcomes and Health Care Resource Utilization of Adult Bacterial Meningitis in the United States.

Neurol Clin Pract 2021 Apr;11(2):117-126

Department of Neurosurgery (MK, SEH, SMA, LTC, BP, SPL), Department of Biostatistics and Bioinformatics (BL, H-JL), and Division of Infectious Diseases, Department of Medicine (JRP), Duke University Medical Center, Durham, NC.

Objective: To examine the longitudinal health care resource utilization, in-hospital mortality, and incidence of downstream complications of bacterial meningitis in the United States.

Methods: Using IBM MarketScan, we retrieved data on adult patients with a diagnosis of bacterial meningitis admitted to a US hospital between 2008 and 2015. Patients were stratified into groups (1) with/without prior head trauma/neurosurgical complications, (2) nosocomial/community acquisition, and (3) Gram-negative/positive bacteria. Read More

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Mechanism, spectrum, consequences and management of hyponatremia in tuberculous meningitis.

Wellcome Open Res 2019 29;4:189. Epub 2021 Mar 29.

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

Hyponatremia is the commonest electrolyte abnormality in hospitalized patients and is associated with poor outcome. Hyponatremia is categorized on the basis of serum sodium into severe (< 120 mEq/L), moderate (120-129 mEq/L) and mild (130-134mEq/L) groups. Serum sodium has an important role in maintaining serum osmolality, which is maintained by the action of antidiuretic hormone (ADH) secreted from the posterior pituitary, and natriuretic peptides such as atrial natriuretic peptide and brain natriuretic peptide. Read More

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Therapeutic drug monitoring of intravenous anti-tuberculous therapy: management of an 8-month-old child with tuberculous meningitis.

Paediatr Int Child Health 2021 Apr 6:1-6. Epub 2021 Apr 6.

Department of Pharmacy, Caen University Hospital, Caen, France.

Tuberculous meningitis (TBM) is now uncommon in high-income countries. It is the most severe form of extrapulmonary tuberculosis with high rates of mortality and morbidity if diagnosis and treatment are delayed. An 8-month-old girl with TBM who was treated with high-dose intravenous anti-tuberculous drugs (ATD) is reported. Read More

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Self-remitting Elevation of Adenosine Deaminase Levels in the Cerebrospinal Fluid with Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: A Case Report and Review of the Literature.

Intern Med 2021 Apr 5. Epub 2021 Apr 5.

Department of Neurology, Nagoya City University Graduate School of Medical Sciences, Japan.

A 29-year-old man presented with a high-grade fever, headache, and urinary retention, in addition to meningeal irritation and myoclonus in his upper extremities. A cerebrospinal fluid (CSF) examination showed pleocytosis and high adenosine deaminase (ADA) levels with no evidence of bacterial infection, including Mycobacterium tuberculosis. T2-weighted brain magnetic resonance imaging showed transient hyper-intensity lesions at the splenium of the corpus callosum (SCC), bilateral putamen, and pons during the course of the disease. Read More

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Cerebrospinal Fluid Analysis.

Am Fam Physician 2021 04;103(7):422-428

Womack Army Medical Center, Fort Bragg, NC, USA.

Cerebrospinal fluid (CSF) analysis is a diagnostic tool for many conditions affecting the central nervous system. Urgent indications for lumbar puncture include suspected central nervous system infection or subarachnoid hemorrhage. CSF analysis is not necessarily diagnostic but can be useful in the evaluation of other neurologic conditions, such as spontaneous intracranial hypotension, idiopathic intracranial hypertension, multiple sclerosis, Guillain-Barré syndrome, and malignancy. Read More

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Meningitis as a recurrent manifestation of anti-AQP4/anti-MOG negative neuromyelitis optica spectrum disorder: a case report.

BMC Neurol 2021 Mar 9;21(1):109. Epub 2021 Mar 9.

Neuroscience Center, General Hospital of Ningxia Medical University, Key Laboratory of Craniocerebral Diseases of Ningxia Hui Autonomous Region, Yinchuan, 75004, China.

Background: Neuromyelitis optica spectrum disorders (NMOSD), a group of autoimmune neurological diseases, involve the optic nerve, spinal cord, and brain. Meningitis is rarely reported as the primary clinical manifestation of both anti-aquaporin-4 (AQP4)/ anti-myelin oligodendrocyte glycoprotein (MOG) antibody-negative NMOSD (NMOSD).

Case Presentation: A 30-year-old man initially presented with fever, headache, and neck stiffness. Read More

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Tracking down the White Plague. Chapter three: Revision of endocranial abnormally pronounced digital impressions as paleopathological diagnostic criteria for tuberculous meningitis.

PLoS One 2021 19;16(3):e0249020. Epub 2021 Mar 19.

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

Abnormally pronounced digital impressions (APDIs) on the endocranial surface develop secondary to a prolonged rise in the intracranial pressure. This can result from a number of pathological conditions, including hydrocephalus due to tuberculous meningitis (TBM). APDIs have been described with relation to TBM not only in the modern medical literature but also in several paleopathological studies. Read More

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The role of optic nerve sheath diameter ultrasound in brain infection.

eNeurologicalSci 2021 Jun 22;23:100330. Epub 2021 Feb 22.

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

Brain infections cause significant morbidity and mortality worldwide, especially in resource-limited settings with high HIV co-infection rates. Raised intracranial pressure [ICP] may complicate brain infection and worsen neurological injury, yet invasive ICP monitoring is often unavailable. Optic nerve sheath diameter [ONSD] ultrasound may allow detection of raised ICP at the bedside; however, pathology in brain infection is different to traumatic brain injury, in which most studies have been performed. Read More

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The impact of common Smurf1 gene variants on the risk, clinical characteristics and short-term prognosis of tuberculous meningitis.

Int J Infect Dis 2021 Mar 9;106:115-122. Epub 2021 Mar 9.

Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guo Xue Alley, Chengdu 610041, China. Electronic address:

Objectives: Tuberculous meningitis (TBM) is the most severe form of infection caused by Mycobacterium tuberculosis (Mtb). Smurf1 represents a key component in anti-Mtb autophagic targeting in macrophages and in anti-TB host defense in vivo. We hypothesized that genetic variants in the Smurf1 gene region influence susceptibility to TBM. Read More

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A pilot study of inflammatory mediators in brain extracellular fluid in paediatric TBM.

PLoS One 2021 12;16(3):e0246997. Epub 2021 Mar 12.

Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.

Tuberculous meningitis (TBM) is the most fatal form of tuberculosis and frequently occurs in children. The inflammatory process initiates secondary brain injury processes that lead to death and disability. Much remains unknown about this cerebral inflammatory process, largely because of the difficulty in studying the brain. Read More

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An Unusual Case of Primary Intracranial Germinoma with Diffuse Subarachnoid Spread Masquerading as Tuberculous Meningitis.

Asian J Neurosurg 2020 Oct-Dec;15(4):1027-1030. Epub 2020 Oct 19.

Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

Central nervous system (CNS) germinomas often extend or disseminate into the ventricular and subarachnoid space. We present a case of primary CNS germinoma consisting mainly of meningeal dissemination, which is extremely unusual and must be kept in the differential diagnosis. Read More

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October 2020

High-dose oral and intravenous rifampicin for the treatment of tuberculous meningitis in predominantly HIV-positive Ugandan adults: a phase II open-label randomised controlled trial.

Clin Infect Dis 2021 Mar 8. Epub 2021 Mar 8.

Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, USA.

Background: High-dose rifampicin may improve outcomes of tuberculous meningitis (TBM). Little safety or pharmacokinetic (PK) data exist on high-dose rifampicin in HIV co-infection, and no cerebrospinal fluid (CSF) PK data exist from Africa. We hypothesized that high-dose rifampicin would increase serum and CSF concentrations without excess toxicity. Read More

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Risk factors for the delayed diagnosis of extrapulmonary TB.

Int J Tuberc Lung Dis 2021 Mar;25(3):191-198

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Department of Internal Medicine, Boramae Medical Center, Seoul.

Extrapulmonary TB (EPTB) is more difficult to diagnose than pulmonary TB. The delayed management of EPTB can lead to complications and increase the socio-economic burden. Patients newly diagnosed with EPTB were retrospectively enrolled from 11 general hospitals in South Korea from January 2017 to December 2018. Read More

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Meningeal tuberculoma: when to consider it?

Rev Soc Bras Med Trop 2021;54. Epub 2021 Mar 8.

Universidade Federal de Pernambuco, Centro de Ciências Médicas, Recife, PE, Brasil.

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Bacillus Calmette-Guerin (BCG): the adroit vaccine.

AIMS Microbiol 2021 8;7(1):96-113. Epub 2021 Feb 8.

Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Background: The Bacillus Calmette-Guerin (BCG) vaccine has been in use for 99 years, and is regarded as one of the oldest human vaccines known today. It is recommended primarily due to its effect in preventing the most severe forms of tuberculosis, including disseminated tuberculosis and meningeal tuberculosis in children; however, its efficacy in preventing pulmonary tuberculosis and TB reactivation in adults has been questioned. Several studies however have found that asides from its role in tuberculosis prevention, the BCG vaccine also has protective effects against a host of other viral infections in humans, an effect which has been termed: heterologous, non-specific or off-target. Read More

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February 2021

Elevated cerebrospinal fluid cytokine levels in tuberculous meningitis predict survival in response to dexamethasone.

Proc Natl Acad Sci U S A 2021 Mar;118(10)

Molecular Immunity Unit, Department of Medicine, University of Cambridge, CB2 0QH Cambridge, United Kingdom;

Adjunctive treatment with antiinflammatory corticosteroids like dexamethasone increases survival in tuberculosis meningitis. Dexamethasone responsiveness associates with a C/T variant in (), which regulates expression of the proinflammatory mediator leukotriene B (LTB). TT homozygotes, with increased expression of , have the highest survival when treated with dexamethasone and the lowest survival without. Read More

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Anti-CD20 Disrupts Meningeal B-Cell Aggregates in a Model of Secondary Progressive Multiple Sclerosis.

Neurol Neuroimmunol Neuroinflamm 2021 05 2;8(3). Epub 2021 Mar 2.

From the Department of Pharmacology (J.R., Y.Z.), University of Oxford; University of Basel (D.L.), Switzerland; Deutsches Rheumaforschungszentrum (DRFZ) and Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin (J.R., A.E.H.), Germany; Roche Innovation Center (E.U.), Basel, Switzerland; and Department of Pharmacology (D.C.A.), University of Oxford, UK.

Objective: Therapies targeting B cells have been used in the clinic for multiple sclerosis (MS). In patients with relapsing MS, anti-CD20 therapy often suppresses relapse activity; yet, their effect on disease progression has been disappointing. Most anti-CD20 therapeutic antibodies are type I, but within the unique microenvironment of the brain, type II antibodies may be more beneficial, as type II antibodies exhibit reduced complement-dependent cytotoxicity and they have an increased capacity to induce direct cell death that is independent of the host immune response. Read More

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Diagnostic Challenges and Prospects Associated With Zoonotic Tuberculosis of Central Nervous System.

Basic Clin Neurosci 2020 Sep-Oct;11(5):619-630. Epub 2020 Sep 1.

Research Centre, Central India Institute of Medical Sciences, Nagpur, Maharashtra, India.

Introduction: The diagnosis of Tuberculous Meningitis (TBM) has remained a challenge due to its insidious onset and the failure of conventional diagnostic tests. The present study aimed to identify the mycobacterial pathogen in the CSF of patients with TBM and a poor prognosis.

Methods: We retrospectively recruited 224 TBM and 34 non-TBM patients admitted to the Central India Institute of Medical Sciences, Nagpur, India, in 2014. Read More

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September 2020