Spectrum of central nervous system tuberculosis: An experience from a large tertiary care institution of India

Ingole, Rajan; Garg, Ravindra Kumar; Malhotra, Hardeep Singh; Jain, Amita; Kumar, Neeraj; Rizvi, Imran

doi:10.1016/j.ijtb.2017.05.011

Cited by 14 publications

(7 citation statements)

References 16 publications

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“…Cerebrospinal Fluid (CSF) analysis revealed a lymphocytic pleocytosis with a leukocyte count of 90 cells (reference range, 0-5), lymphocyte predominance (87%), raised protein of 236 mg/dL (reference range, 15-60 mg/100 mL), low CSF glucose 18 mg/dL (reference range, 50-80 mg/100 mL). CSF Gram stain, culture, and sensitivity were negative for all bacteria suspicion of tuberculous meningitis difficult [4]. Other clinical presentations may include hydrocephalus caused by disturbance of CSF circulation and seizures caused by parenchymal damage.…”

Section: Discussionmentioning

confidence: 97%

Tuberculous Meningitis in an Immunocompetent Host: A Diagnostic Challenge

Algahtani¹,

Shirah²,

Abdelghaffar³

et al. 2020

DSAHMJ

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Section: Discussionmentioning

confidence: 97%

Tuberculous Meningitis in an Immunocompetent Host: A Diagnostic Challenge

Algahtani¹,

Shirah²,

Abdelghaffar³

et al. 2020

DSAHMJ

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“…Most patients with intracranial TB die within the first six months, especially those with miliary TB. Early diagnosis and treatment is an important factor in improving the prognosis of patients with intracranial TB (9)(10)(11). The gold standard for the diagnosis of intracranial TB is positive CSF smear or culture (9).…”

Section: Discussionmentioning

confidence: 99%

Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis

Yang

Wang

et al. 2021

Acta Radiol

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Background Intracranial tuberculosis (TB) is an intracranial infection caused by Mycobacterium tuberculosis. Magnetic resonance imaging (MRI), in particular enhanced MRI scan, has the ability to detect characteristic lesions of tuberculous meningitis or cerebral parenchymal TB. Purpose To analyze the relationship between MRI findings and prognosis of patients with intracranial TB. Material and Methods In this retrospective study, a total of 60 patients were confirmed with intracranial TB in the hospital from May 2019 to December 2020. All enrolled patients underwent TB-related laboratory examinations, cranial MRI, and contrast-enhanced MRI. Laboratory tests were analyzed and the relationship between clinical prognosis and cranial MRI features was evaluated. Results Of the 60 patients, 28 (46.67%) had disseminated TB complications, 20 (36.67%) had secondary TB complications, and the remaining 10 (16.66%) had lymphatic TB or spinal TB complications. Of the patients, 25 had good short-term prognosis and 35 had poor short-term prognosis; 44 patients had good long-term prognosis and 16 had poor long-term prognosis. The incidence of cerebral parenchymal tuberculomas on enhanced MRI was significantly higher in the group with good prognosis compared to that in the group with poor prognosis ( P < 0.05). Logistic analysis suggested that hydrocephalus (odds ratio [OR] = 0.057, 95% confidence interval [CI] = 0.003–0.444; P = 0.018) and cistern involvement (OR = 0.100, 95% CI = 0.011–0.581; P = 0.017) were independent risk factors for poor short-term prognosis. Conclusion MRI can display the pathological changes of intracranial TB in detail; hydrocephalus and cistern involvement were independent risk factors for poor short-term prognosis.

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“…The symptoms of HIV positive patients were similar to HIV negative patients although they have higher frequency of extra neural TB as earlier reported. [20] The presence of extra neural TB along with greater stage of the disease and baseline modified Barthel index<12 were found to be associated with poor outcomes in a prospective study by R.Ingole et al [21] The past studies were utilized to recognize and evaluate the factors which served as poor prognostic markers and their prognostic values were equivalent to 2/3rd of serum. Thus these findings were comparable to various studies.…”

Section: Malik and Singh: Clinical Correlates Of Tubercular Meningitismentioning

confidence: 99%

Study of Clinical Correlates of Tubercular Meningitis in a Tertiary Care Centre in Moradabad

Malik¹,

Singh²

2019

AJM

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Background: Tuberculosis continues to remain a leading cause of mortality worldwide with tubercular meningitis being the most common type of central nervous system tuberculosis that is associated with significant morbidity and mortality if not identified and treated promptly. Due to meager amount of published data and lack of evaluation of the western UP population, this study was conducted in order to observe a detailed clinical course of the disease as well as to analyze predictors of morbidity and mortality in patients of TBM admitted at a tertiary care hospital in Moradabad.Subjects and Methods: A total of 120 patients with diagnosis of TBM as per the diagnostic criteria of the study were included and all their information and features recorded and treatment done as per guidelines and a follow-up done at 3 months using Barthel Index.Results: Multivariate logistic regression analysis of various factors revealed age of the patient (p=0.04), duration of symptoms (p=0.002), stage of TBM on presentation (p=0.001), TLC>9000 (p=0.006), low CSF glucose (p=0.01), hyponatremia (p=0.04), hypoalbuminemia (p=0.007) and hydrocephalus (p=0.04) on neuroimaging were significant risk factors of mortality and morbidity in adult patients of TBM.Conclusion: The current study may provide components for the composition of a score to predict outcome using the significant poor prognostic factors that were recognized in this study. This can be utilised for prompt employment of rigorous management remedies in order to reduce patients' morbidity and mortality.

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Spectrum of central nervous system tuberculosis: An experience from a large tertiary care institution of India

Cited by 14 publications

References 16 publications

Tuberculous Meningitis in an Immunocompetent Host: A Diagnostic Challenge

Tuberculous Meningitis in an Immunocompetent Host: A Diagnostic Challenge

Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis

Study of Clinical Correlates of Tubercular Meningitis in a Tertiary Care Centre in Moradabad

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