Tuberculous meningitis: The challenges

Murthy, J. M. K.

doi:10.4103/0028-3886.72178

Cited by 80 publications

(63 citation statements)

References 69 publications

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“…During adulthood, TB infection rates are consistently higher for men than for women; the male-to-female ratio is approximately 2:1. 6,13 In our series too there was a slight male predominance in TBM subgroup.…”

Section: Tubercular Meningitis Hydrocephalusmentioning

confidence: 79%

Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Tyagi¹,

Balasubramaniam²,

Jayaswal

et al. 2016

Int J Contemp Pediatr

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Section: Tubercular Meningitis Hydrocephalusmentioning

confidence: 79%

Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Tyagi¹,

Balasubramaniam²,

Jayaswal

et al. 2016

Int J Contemp Pediatr

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“…After the first acute seizure, TBM patients commonly experience recurrent seizures unless treated with antiepileptic drug prophylaxis; benzodiazepines in the acute phase, then phenytoin/fosphenytoin and subsequent maintenance therapy. Valproic acid should be avoided if possible due to hepatotoxicity [88].…”

Section: Specific Antituberculous Treatmentmentioning

confidence: 99%

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

2012

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Tuberculous meningitis (TBM) is the most severe form of TB. Despite treatment, mortality and long-term disability remain unacceptably high. Prevention, early recognition, diagnosis and treatment are fundamental to improving outcomes. However, an effective vaccine remains elusive, initial symptoms are nonspecific, and sensitive diagnostic tests are not available. There has been progress in our understanding of the immunopathology of TBM, and several factors have been found to be associated with susceptibility to infection, disease progression and clinical outcome. However, these have not yet impacted on treatment. Early treatment initiation and uninterrupted continuation, severity on presentation, seizures, stroke, cranial nerve involvement, cerebrospinal fluid cell count and lactate levels, hyponatreamia and coinfection with HIV are all found to be important prognostic factors for outcome. Pathogen lineage (Beijing genotype) and host genetics (polymorphisms in TLR2, TIRAP and LTA4H genes) can influence susceptibility to TBM. However, these findings have not yet impacted on treatment. Progress in vaccine development, opportunities for better diagnostic tests, novel insights into pathogenesis and an increasing evidence base for improving treatment should impact the current high mortality and morbidity, if translated to global and local guidelines.

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“…Delay in diagnosis is associated with high mortality and morbidity due to sequelae. 3 Early and correct treatment is essential for a successful outcome in patients of tuberculous meningitis.…”

Section: Introductionmentioning

confidence: 99%

Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

Thapa¹,

Reddy²

2017

Int J Contemp Pediatr

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Background: Early and correct treatment is essential for successful outcome in patients of tuberculous men-ingitis. Adenosine deaminase activity in the cerebrospinal fluid has been found to be a simple and useful investigation in the diagnosis of tuberculous meningitis in children.Methods: It is a cross sectional observational hospital based study conducted at the Department of Paediatrics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, India. Children aged 2 months to 12 years were included in the study during April 2016 to October 2016.Results: The mean value of adenosine deaminase activity in the cerebrospinal fluid of tuberculous meningitis cases was 13.3±14.49. The mean cerebrospinal fluid adenosine deaminase levels in tuberculous meningitis patients was significantly higher than non-tuberculous meningitis patients with P <0.01.Conclusions: The mean cerebrospinal fluid adenosine deaminase level was significantly raised in tuberculous meningitis patients.

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Tuberculous meningitis: The challenges

Cited by 80 publications

References 69 publications

Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Outcome analysis of ventriculoperitoneal shunt procedures in hydrocephalus due to tubercular meningitis and non-infective cases

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

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