Fulminant Tuberculous Meningitis

Shinoyama, Mizuya; Suzuki, Michiyasu; Nomura, Sadahiro

doi:10.2176/nmc.52.761

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Laboratory data may not be completely useful in most cases with meningitis due to M. tuberculosis (26). In 85z of patients with M. tuberculosis, the CSF glucose concentration is often lower than the normal range, while the CSF protein level may be increased (27).…”

Section: Discussionmentioning

confidence: 99%

Acute Bacterial Meningitis among Children Admitted into an Iranian Referral Children's Hospital

et al. 2013

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SUMMARY: Bacterial meningitis is a serious threat to global health, particularly in developing countries. The aim of this study was to determine the etiological agents of acute bacterial meningitis, its clinical features, and antibacterial susceptibility among Iranian children who were admitted to a referral regional children's hospital. Laboratory data as well as symptoms and signs on admission, organism identification and antibiotic susceptibility results, physical examination findings, and neurologic features of 31 patients with suspected invasive bacterial infection were evaluated, of which 20 (64.5z) had positive cerebrospinal fluid (CSF) cultures. The microorganisms most commonly associated with bacterial meningitis in children were Streptococcus pneumoniae (7 isolates, 22.5z), Haemophilus influenzae (3 isolates, 10z), and Neisseria meningitidis (3 isolates, 10z). In our study, the rate of mortality and sequelae were 10z and 35z, respectively. Ventriculomegaly hydrocephalus was found in 1 case positive for Mycobacterium tuberculosis meningitis, while other signs of meningitis were negative. According to our results, abnormalities including brain edema, subdural effusion, microabscess, and ventriculomegaly hydrocephalus were observed in 50z of the patients with confirmed bacterial meningitis; therefore, identification of predictors of early neurological complications is highly recommended. In addition, CSF culture using the BACTEC automated system is recommended for detection of the etiologic agents of bacterial meningitis, particularly in a population like ours, in which the patients receive a course of antibiotics without prescription.

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Section: Discussionmentioning

confidence: 99%

Acute Bacterial Meningitis among Children Admitted into an Iranian Referral Children's Hospital

et al. 2013

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“…Exudate coats all the major vessels in the Circle of Willis, with a predilection for the middle cerebral arteries, as well as their small perforators ( 163 ). This results in inflammation of the vessel wall, vascular occlusion, and vasospasm, which put the brain at significant risk of ischemia and infarction, commonly seen in the basal ganglia ( 169 , 170 ).…”

Section: Tuberculous Meningitismentioning

confidence: 99%

Bacterial meningitis in Africa

Barichello

Catalão²,

Rohlwink³

et al. 2023

Front. Neurol.

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Bacterial meningitis differs globally, and the incidence and case fatality rates vary by region, country, pathogen, and age group; being a life-threatening disease with a high case fatality rate and long-term complications in low-income countries. Africa has the most significant prevalence of bacterial meningitis illness, and the outbreaks typically vary with the season and the geographic location, with a high incidence in the meningitis belt of the sub-Saharan area from Senegal to Ethiopia. Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are the main etiological agents of bacterial meningitis in adults and children above the age of one. Streptococcus agalactiae (group B Streptococcus), Escherichia coli, and Staphylococcus aureus are neonatal meningitis's most common causal agents. Despite efforts to vaccinate against the most common causes of bacterial neuro-infections, bacterial meningitis remains a significant cause of mortality and morbidity in Africa, with children below 5 years bearing the heaviest disease burden. The factors attributed to this continued high disease burden include poor infrastructure, continued war, instability, and difficulty in diagnosis of bacterial neuro-infections leading to delay in treatment and hence high morbidity. Despite having the highest disease burden, there is a paucity of African data on bacterial meningitis. In this article, we discuss the common etiologies of bacterial neuroinfectious diseases, diagnosis and the interplay between microorganisms and the immune system, and the value of neuroimmune changes in diagnostics and therapeutics.

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“…The characteristic feature of TBM in post‐mortem studies is the presence of a thick, gelatinous inflammatory exudate in the basal cisterns and subarachnoid spaces of the brain (Fig. ), which may extend into the spinal canal . The predominantly basal location has important implications; first, the major cerebral vessels originating from the base of the brain become encased with exudate; second, exudate blocks the circulation of CSF; and third, it envelopes and compresses the local cranial nerves resulting in cranial nerve palsies…”

Section: Macroscopic Manifestations Of the Disease In Relation To Thementioning

confidence: 99%

The pathogenesis of tuberculous meningitis

Davis

Rohlwink

Proust

et al. 2019

Journal of Leukocyte Biology

139

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Tuberculosis (TB) remains a leading cause of death globally. Dissemination of TB to the brain results in the most severe form of extrapulmonary TB, tuberculous meningitis (TBM), which represents a medical emergency associated with high rates of mortality and disability. Via various mechanisms the Mycobacterium tuberculosis (M.tb) bacillus disseminates from the primary site of infection and overcomes protective barriers to enter the CNS. There it induces an inflammatory response involving both the peripheral and resident immune cells, which initiates a cascade of pathologic mechanisms that may either contain the disease or result in significant brain injury. Here we review the steps from primary infection to cerebral disease, factors that contribute to the virulence of the organism and the vulnerability of the host and discuss the immune response and the clinical manifestations arising. Priorities for future research directions are suggested. K E Y W O R D S mycobacterial, endothelial cells, granulocytes, microglia cells, monocytes/macrophages, myeloid cells, neutrophils, T Lymphocytes, Th17 cells at the site of infection activates macrophages and DCs to produce cytokines and antimicrobial factors that contribute to containment of the TB bacillus. 2 This inflammatory process results in the formation of a granuloma, which encapsulates the infected cells and retards the replication of TB bacilli and can lead to latent infection. However, in

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Fulminant Tuberculous Meningitis

Cited by 4 publications

References 16 publications

Acute Bacterial Meningitis among Children Admitted into an Iranian Referral Children's Hospital

Acute Bacterial Meningitis among Children Admitted into an Iranian Referral Children's Hospital

Bacterial meningitis in Africa

The pathogenesis of tuberculous meningitis

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