Tuberculous meningitis and miliary tuberculosis in Iran

Abstract

In recent years, the number of cases of extrapulmonary tuberculosis in Iran has increased. The goal of this study was to determine the epidemiological status, clinical symptoms, diagnostic methods, and treatment strategies of extrapulmonary tuberculosis in Iran, with a focus on tuberculosis meningitis and miliary tuberculosis. Between January 1, 2000 and June 1, 2021, 1 651 cases of tuberculosis meningitis and miliary tuberculosis were discovered in Iran. The prevalence of tuberculosis meningitis was higher in Sistan and Baluchestan, South Khorasan, and Mazandaran compared with other provinces. The most prevalent symptoms of tuberculous meningitis were fever, anorexia, headache, neck stiffness, loss of consciousness, and vomiting. The most commonly used procedures for diagnosing tuberculous meningitis were polymerase chain reaction and cerebrospinal fluid culture. The most prevalent clinical symptoms of miliary tuberculosis were fever, lethargy, weariness, and anorexia. In 70% of chest radiographs, a miliary pattern was visible. Bone marrow biopsy was used to diagnose miliary tuberculosis in 80% of patients, while bronchoalveolar lavage was used in 20% of cases. The conventional 6-month treatment approach for tuberculous meningitis and miliary tuberculosis was used for all of the participants in the investigations. Given the high prevalence of extrapulmonary tuberculosis patients in Iran and the devastating consequences of the disease, the researchers recommend that further study be done to prevent extrapulmonary tuberculosis in the general population.

Clinical and mycological implications of cryptococcal meningitis in Iran

“…Diagnosing CM can be challenging due to the lack of information or awareness about distinguishing it from acute meningitis, as well as the similar epidemiological, clinical, and laboratory characteristics of other subacute meningitis cases reported in immunocompromised patients such as tuberculosis. Haemophilus influenza type B meningitis due to a lack of routine vaccination and tuberculous meningitis is more common than CM in Iran, which can lead to misdiagnosis and incorrect treatment, as seen in one patient in our study [ 31 , 32 ]. The use of steroids to manage underlying conditions might mask the clinical symptoms of CM, leading to delayed recognition and treatment initiation.…”

Post-tuberculous meningitis hydrocephalous- A case report

“…Sistan, Baluchestan, South Khorasan, and Mazandaran had greater rates of TB meningitis than other provinces. Fever, anorexia, headache, stiff neck, loss of consciousness, and vomiting were the most typical signs of tuberculous meningitis (1). The frequent complication of TBM is hydrocephalus, which can occur in up to 85% of affected children.…”

“…The bacilli may develop tiny sub-pial or sub-ependymal rich foci. These rich foci get larger as the illness worsens and may finally burst into the sub-arachnoid region, causing meningitis (1) . Tuberculous meningitis is linked to a high mortality rate.…”