8,786 results match your criteria Tuberculous Meningitis


[Tuberculous Meningitis in Which Inflammation Cannot Be Adequately Suppressed by Standard Therapy: How to Think and Treat].

Brain Nerve 2022 May;74(5):427-432

Department of Neurology, Yamaguchi Prefectural Grand Medical Center.

Tuberculous meningitis is the most severe form of tuberculosis and often causes critical illness with high mortality. Treatment should be initiated without waiting for a definitive diagnosis of tuberculous meningitis. Although we often experience treatment-resistant tuberculous meningitis, it is important to continue examination and treatment. Read More

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[Tuberculous Meningitis in Which Inflammation Cannot Be Adequately Suppressed by Standard Therapy: Treatment-Resistant Tuberculous Meningitis].

Brain Nerve 2022 May;74(5):421-426

Neurology, Kouhoukai Takagi Hospital.

To understand tuberculous meningitis (TBM), its clinical features and standard therapy were briefly reviewed. In addition, to determine the therapeutic strategies for treatment-resistant TBM, several clinical cases, including those with paradoxical reaction, ventriculitis, cerebral tuberculoma, and human immunodeficiency virus (HIV) co-infection, are presented. Steroid pulse therapy and intrathecal isoniazid administration are discussed as specific therapeutic strategies. Read More

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Intracranial necrotising sarcoid granulomatosis mimicking petroclival meningioma.

BMJ Case Rep 2022 May 17;15(5). Epub 2022 May 17.

Neurology, Meitra Hospital, Calicut, India.

We present a unique case of biopsy-proven necrotising sarcoidosis involving the central nervous system in a man in his 40s. The patient presented with a 2-week history of right-sided headache and diplopia. He had right trochlear and abducens nerve palsy, sensory blunting over V1 and V2 segment of right trigeminal sensory nerve and right sensory neural hearing loss. Read More

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Diagnostic Accuracy of Interferon-Gamma Release Assays for Tuberculous Meningitis: A Systematic Review and Meta-Analysis.

Front Cell Infect Microbiol 2022 22;12:788692. Epub 2022 Apr 22.

Department of Neurology, Jiangxi Provincial People's Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, China.

Background: In this study, we evaluated and compared the accuracy of blood and cerebrospinal fluid (CSF) interferon release tests [interferon-gamma release assays (IGRAs)] in the diagnosis of tuberculous meningitis (TBM) by a meta-analysis of the relevant literature.

Methods: We searched for studies published before 2021 in Medline, Embase, the Cochrane database, and Chinese databases. All studies used the QuantiFERON-TB Gold In-Tube and/or T-SPOT. Read More

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Tuberculous Skull Base Osteomyelitis With Cerebral Venous Sinus Thrombosis in an Immunocompetent Adolescent: A Case Report.

Cureus 2022 Apr 6;14(4):e23865. Epub 2022 Apr 6.

General Medicine, All India Institute of Medical Sciences, Raipur, IND.

Skull-base osteomyelitis is a rare yet lethal entity. It is infrequently observed among immunocompetent children and young adults, and Mycobacterium is much less common among the various bacterial and fungal etiological causes noted. We report a rare case of a 17-year immunocompetent girl who presented with complaints of head and neck pain and restricted neck movements. Read More

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Successful treatment of linezolid-induced severe lactic acidosis with continuous venovenous hemodiafiltration: A case report.

Saudi Pharm J 2022 Feb 31;30(2):108-111. Epub 2021 Dec 31.

Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Medical Center for Clinical Pharmacy, Jiangsu, Nanjing 210008, PR China.

Linezolid is an oxazolidinone antibiotic. Linezolid-associated lactic acidosis has been reported in 6.8% of linezolid-treated patients. Read More

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February 2022

Extrapulmonalis tuberculosis - diagnosztikai és terápiás kihívás.

Orv Hetil 2022 May 8;163(19):750-757. Epub 2022 May 8.

1 Marosvásárhelyi "George Emil Palade" Orvosi, Gyógyszerészeti, Tudomány- és Technológiai Egyetem, Tüdőgyógyászati Tanszék Marosvásárhely Romania.

Összefoglaló. Bevezetés: Az extrapulmonalis tuberculosis incidenciája növekvő tendenciát mutat annak ellenére, hogy az elmúlt években világszerte csökkent a tuberculosisos esetek száma. Célkitűzés: Az extrapulmonalis tuberculosisra hajlamosító tényezők felmérése és a bakteriológiai és szövettani diagnosztizálási arányok meghatározása az egyes formák esetén. Read More

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Life-threatening disseminated tuberculosis masquerading as cervical spondylosis---Case report "Cervical TB v/s Cervical Spondylosis".

J Family Med Prim Care 2022 Apr 18;11(4):1558-1560. Epub 2022 Mar 18.

Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Tuberculosis (TB) is quite prevalent in developing countries, with an ever-rising incidence of extrapulmonary cases. TB of bones and joints is quite challenging to diagnose. Most spinal TB lesions localize at the thoracic and lumbar levels; cervical lesions are a rarity. Read More

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Validation of host cerebrospinal fluid protein biomarkers for early diagnosis of tuberculous meningitis in children: a replication and new biosignature discovery study.

Biomarkers 2022 May 12:1-13. Epub 2022 May 12.

DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research; South African Medical Research Council Centre for Tuberculosis Research; Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

The diagnosis of tuberculous meningitis (TBM) in children is often delayed due to diagnostic difficulties. New tools are urgently needed to improve the diagnosis of the disease in this vulnerable group. The present study aimed to validate the accuracy of recently identified host cerebrospinal (CSF) biomarkers as candidates for the diagnosis of TBM in children. Read More

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[A case of tuberculous meningoencephalomyelitis].

Zh Nevrol Psikhiatr Im S S Korsakova 2022 ;122(4):135-143

Regional Clinical Phthisiopulmonology Center, Tyumen, Russia.

Tuberculosis of the central nervous system has a large proportion among all extrapulmonary tuberculous lesions forms and is an urgent and socially significant problem, despite the development and availability of modern diagnostic methods (radiation diagnostics, cerebrospinal fluid PCR) and treatment. A high disability and mortality level in tuberculous meningoencephalomyelitis is often caused by an untimely clinical diagnosis, which may be associated with an atypical clinical picture of the disease, as well as insufficient information content of the results of instrumental and immunological examination. The authors present a case of tuberculous meningoencephalomyelitis in a female patient without concomitant HIV infection, in the absence of manifestations of visceral, including pulmonary, tuberculosis throughout the disease. Read More

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A Fatal Case of Tuberculosis Meningitis in Previously Health Children.

Pediatr Rep 2022 Apr 9;14(2):175-180. Epub 2022 Apr 9.

Clinical Pharmacology and Pharmacovigilance Unit Mater Domini Hospital, 88100 Catanzaro, Italy.

Tuberculous meningitis (TBM) is a severe form of tuberculosis. We report the development of fatal TBM in a 2-year-old previously healthy child, suggesting that TBM must be evaluated in children of all ages with non-specific symptoms of central nervous involvement because a diagnostic delay induces a negative prognosis. Read More

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A Case Series on Neuropathogenic Nature of an Ancient Disease ----Tuberculosis.

J Assoc Physicians India 2022 Apr;70(4):11-12

Sms Medical College and Attached Hospital, Jaipur, Rajasthan.

Tuberculosis is one of the oldest diseases known to affect humans and the top cause of infectious death worldwide caused by M. tuberculosis complex. Tuberculosis may be pulmonary, extra-pulmonary or both. Read More

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A New Scoring System to Differentially Diagnose and Distinguish Tuberculous Meningitis and Bacterial Meningitis in South China.

Front Neurol 2022 30;13:830969. Epub 2022 Mar 30.

Department of Pediatrics, Jiangxi Provincial People's Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, China.

Background: Tuberculous meningitis (TBM) is the most serious form of extrapulmonary tuberculosis caused by , and is characterized by high morbidity and mortality. Unfortunately, it is difficult to distinguish TBM from bacterial meningitis (BM) based on clinical features alone. The latest diagnostic tests and neuroimaging methods are still not available in many developing countries. Read More

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Effectiveness of Bacillus Calmette-Guérin vaccination against severe childhood tuberculosis in China: a case-based, multicenter retrospective study.

Int J Infect Dis 2022 Apr 13. Epub 2022 Apr 13.

Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China. Electronic address:

Background: Evidence varies regarding the efficacy of Bacillus Calmette-Guérin (BCG) vaccine. Data on protection by BCG vaccination against severe tuberculosis (TB) among children in China remains unclear.

Methods: We conducted a case-based, multicenter retrospective study at three children's hospitals in China. Read More

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Tuberculous meningitis: progress and remaining questions.

Lancet Neurol 2022 05;21(5):450-464

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, UK; Oxford University Clinical Research Unit, Centre for Tropical Medicine, Ho Chi Minh City, Vietnam. Electronic address:

Tuberculous meningitis is a devastating brain infection that is caused by Mycobacterium tuberculosis and is notoriously difficult to diagnose and treat. New technologies characterising the transcriptome, proteome, and metabolome have identified new molecules and pathways associated with tuberculous meningitis severity and poor outcomes that could offer novel diagnostic and therapeutic targets. The next-generation GeneXpert MTB/RIF Ultra assay, when used on CSF, offers diagnostic sensitivity for tuberculous meningitis of approximately 70%, although it is not widely available and a negative result cannot rule out tuberculous meningitis. Read More

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Update on the Treatment of Pediatric Tuberculous Meningitis.

Pediatr Infect Dis J 2022 Apr 11. Epub 2022 Apr 11.

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

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Clinical Efficacy of Dexamethasone in the Treatment of Patients with Tuberculous Meningitis: A Meta-Analysis.

Contrast Media Mol Imaging 2022 30;2022:2180374. Epub 2022 Mar 30.

Department of Neurology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750002, China.

Objective: This study aimed to systematically evaluate the clinical efficacy of dexamethasone in patients with tuberculous meningitis (TBM) through meta-analysis.

Method: PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and the Wanfang Databases were searched, and all relevant Chinese and English literature from 2000 to 2021 were retrieved from each database. We collected randomized controlled trials of conventional antituberculosis drugs combined with dexamethasone treatment (treatment group) and conventional antituberculosis drug treatment or combined with placebo treatment (control group) in TBM patients. Read More

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Deciphering Genetic Susceptibility to Tuberculous Meningitis.

Front Neurol 2022 25;13:820168. Epub 2022 Mar 25.

DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculosis (TB) that arises when a caseating meningeal granuloma discharges its contents into the subarachnoid space. It accounts for ~1% of all disease caused by and the age of peak incidence is from 2-4 years. The exact pathogenesis of TBM is still not fully understood and the mechanism(s) by which the bacilli initially invade the blood-brain-barrier are still to be elucidated. Read More

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Chronic meningitis misdiagnosed as polymyalgia rheumatica and successfully treated with voriconazole.

Clin Case Rep 2022 Apr 4;10(4):e05664. Epub 2022 Apr 4.

Department of Neuropathology University Medicine Göttingen Göttingen Germany.

The outcome of chronic meningitis depends to a large degree on the causative pathogen and the interval between onset of symptoms and diagnosis. We present a patient with a delayed diagnosis and several complications, for whom adequate therapy resulted in a favorable outcome. In a 76-year-old male patient,   meningitis was diagnosed 4 months after the onset of symptoms. Read More

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Tuberculous Granuloma: Emerging Insights From Proteomics and Metabolomics.

Front Neurol 2022 21;13:804838. Epub 2022 Mar 21.

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

infection, which claims hundreds of thousands of lives each year, is typically characterized by the formation of tuberculous granulomas - the histopathological hallmark of tuberculosis (TB). Our knowledge of granulomas, which comprise a biologically diverse body of pro- and anti-inflammatory cells from the host immune responses, is based mainly upon examination of lungs, in both human and animal studies, but little on their counterparts from other organs of the TB patient such as the brain. The biological heterogeneity of TB granulomas has led to their diverse, relatively uncoordinated, categorization, which is summarized here. Read More

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Clinical, laboratory and evolutionary features of abdominal tuberculosis in comparison with other forms of extrapulmonary tuberculosis.

Indian J Tuberc 2022 Apr 5;69(2):184-190. Epub 2021 Aug 5.

Infectious Diseases Department and Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, University of Sfax, Tunisia.

Background/objectives: Tuberculosis is a multisystem disease that might affect any organ. Abdominal tuberculosis (ABT) represents 5-17% from all extrapulmonary tuberculosis (EPT) sites. We aimed to study the clinical, laboratory and evolutionary features of ABT cases and to identify predictive factors associated with ABT. Read More

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Predictors of outcomes in children with Central Nervous System tuberculosis.

Indian J Tuberc 2022 Apr 17;69(2):166-171. Epub 2021 Jun 17.

Department of Paediatrics, Grant Government Medical College and Sir JJ Group of Hospitals, Byculla, Mumbai, 400008, India.

Background: Central Nervous system tuberculosis (CNS-Tb) is the most lethal form of extra-pulmonary tuberculosis in children. The lack of markers of outcome provides little information on the efficacy of the current treatment protocols for CNS-Tb and thus results in a higher mortality rate than other extrapulmonary manifestations of tuberculosis. This study aims to identify significant factors that will reliably predict the outcomes at discharge in children admitted with CNS-Tb. Read More

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Trevor Mann (1916-1996): Paediatrician responsible for the development of hospital services for children in Brighton, England.

J Med Biogr 2022 Apr 4:9677720221090876. Epub 2022 Apr 4.

152127Department of Primary Care and Public Health, 12190Brighton and Sussex Medical School, Brighton, UK.

Trevor Philip Mann (1916-1996) was the first consultant paediatrician at the Royal Alexandra Children's Hospital (RACH) in Brighton, since its foundation in 1881. Here, he was responsible for significant service developments, including establishing a department of paediatric surgery and the first neonatal unit in England outside of London. Mann grew up in South London, and aged 14 had a lengthy admission to hospital with tuberculosis. Read More

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The challenge of differentiating tuberculous meningitis from bacterial meningitis.

Respirol Case Rep 2022 Mar 20;10(3):e0910. Epub 2022 Feb 20.

Department of Respiratory Medicine and Clinical Immunology National Hospital Organization Utsunomiya Hospital Tochigi Japan.

Tuberculous meningitis (TBM) is a rare but important differential diagnosis in patients with impaired consciousness. Here, we describe a case of TBM in an 83-year-old Japanese woman who presented to a local hospital with fever and decreased consciousness of 20 days' duration (from day -40). She was started on treatment for bacterial meningitis due to an increased cerebrospinal fluid cell count, but her condition did not improve. Read More

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Myelitis: A Common Complication of Tuberculous Meningitis Predicting Poor Outcome.

Front Neurol 2022 16;13:830029. Epub 2022 Mar 16.

Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Background: Myelitis is an important complication in patients with tuberculous meningitis (TBM). However, a paucity of publications exists on the spectrum of neurological and MRI findings of TBM-related myelitis. The risk factors and prognosis of myelitis in patients with TBM are not fully understood. Read More

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Tuberculous Meningitis in Children: A Forgotten Public Health Emergency.

Front Neurol 2022 17;13:751133. Epub 2022 Mar 17.

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

Tuberculous meningitis (TBM) remains a major cause of morbidity and mortality in children with tuberculosis (TB), yet there are currently no estimates of the global burden of pediatric TBM. Due to frequent non-specific clinical presentation and limited and inadequate diagnostic tests, children with TBM are often diagnosed late or die undiagnosed. Even when diagnosed and treated, 20% of children with TBM die. Read More

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Integrating central nervous system metagenomics and host response for diagnosis of tuberculosis meningitis and its mimics.

Nat Commun 2022 03 30;13(1):1675. Epub 2022 Mar 30.

Infectious Diseases Institute, Makerere University, Kampala, Uganda.

The epidemiology of infectious causes of meningitis in sub-Saharan Africa is not well understood, and a common cause of meningitis in this region, Mycobacterium tuberculosis (TB), is notoriously hard to diagnose. Here we show that integrating cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) with a host gene expression-based machine learning classifier (MLC) enhances diagnostic accuracy for TB meningitis (TBM) and its mimics. 368 HIV-infected Ugandan adults with subacute meningitis were prospectively enrolled. Read More

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Performance of Xpert MTB/RIF and Xpert Ultra for the diagnosis of tuberculous meningitis in children.

Int J Tuberc Lung Dis 2022 04;26(4):317-325

Department of Neurology, Columbia University Irving Medical Center and the New York Presbyterian Hospital, New York, NY, USA.

To assess Xpert MTB/RIF (Xpert) and Xpert MTB/RIF Ultra (Ultra) performance in diagnosing pediatric tuberculous meningitis (TBM). We conducted a study among children with suspected meningoencephalitis in Pune, India. Clinical, radiological, laboratory, and treatment data were analyzed to classify disease as definite, probable, possible or no TBM, using microbiologic or composite reference standards. Read More

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Ventriculoperitoneal shunt is associated with increased cerebrospinal fluid protein level in HIV-infected cryptococcal meningitis patients.

BMC Infect Dis 2022 Mar 26;22(1):286. Epub 2022 Mar 26.

National Clinical Research Center for Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Background: The impact of ventriculoperitoneal shunt on cerebrospinal fluid (CSF) biochemical profiles in HIV-associated cryptococcal meningitis (HCM) patients remains unclear.

Methods: Twenty-nine HCM patients who underwent ventriculoperitoneal shunt (the VPS group) and 57 HCM patients who did not undergo ventriculoperitoneal shunt (the non-VPS group) were enrolled in this propensity score matching analysis. Demographic characteristics, symptoms, CSF biochemical profiles, and adverse events were compared between the two groups. Read More

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Tuberculosis Meningitis in People Living with HIV/AIDS in a Health Center in the Brazilian Amazon: A Silent Disease.

Case Rep Infect Dis 2022 14;2022:8048310. Epub 2022 Mar 14.

Federal University of Para, Belém, Brazil.

Introduction: Tuberculosis (TB) is one of the ten leading causes of death worldwide and the leading cause of infection in people living with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). It is a major public health problem in Brazil and worldwide.

Methods: This was a case series study of five meningeal tuberculosis and PLWHA coinfection patients admitted between June 2019 and June 2020, in a public hospital in the northern region of Brazil. Read More

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