Total delay in treatment among tuberculous meningitis patients in China: a retrospective cohort study

AbstractIntroductionTuberculosis (TB) remains as an important concern of public health worldwide because the high prevalence and severe sequelae. Tuberculous meningitis (TBM) is the most lethal and disabling form.AimTo describe the clinical, laboratory, and neuroimaging characteristics of TBM on admission at neurological center in Mexico City.MethodsRetrospective cohort study at the third level neurological center from 2010 to 2016. Clinical follow-up was evaluated at hospital discharge, three months, and one-year either due to lack of follow-up or mortality, during the follow-up the adverse events were registered.ResultsOne-hundred and six patients were included, 74 (69.8%) males and 32 (30.2%) females. From these 31 (29.2%) were HIV-positive. The median age was 35.5 (IQR:28-51). Pulmonary TB was found in 25% of the population. Alcoholism was observed in a half of the patients while diabetes in 15%, the latter being significant (p=0.04). Abnormalities in neuroimaging were significant among our population (p=0.003). Only one-third of the population had a positive Lowenstein-Jensen culture. There were no differences in clinical outcomes between HIV positive and non-HIV patients.ConclusionOur study shows data to those described in the literature. The initiation of empirical treatment in all patients with a high clinical suspicion of tuberculosis mandatory to try to avoid severe neurological sequels.

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Delay in Treatment of Neonatal Seizures: A Retrospective Cohort Study

Neonatology ◽

10.1159/000509282 ◽

2020 ◽

pp. 1-7

Author(s):

Wievineke M.J. Apers ◽

Linda S. de Vries ◽

Floris Groenendaal ◽

Mona C. Toet ◽

Lauren C. Weeke

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Neonatal Seizures ◽

Delay In Treatment

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Presentation, Clinical Characteristics, and Treatment Outcomes among Tuberculous Meningitis Patients with and Without HIV Infection at Vajira Hospital, Thailand: A Retrospective Cohort Study

Journal of the International Association of Providers of AIDS Care (JIAPAC) ◽

10.1177/23259582211045551 ◽

2021 ◽

Vol 20 ◽

pp. 232595822110455

Author(s):

Lakkana Boonyagars ◽

Chunlanee Sangketchon ◽

Kittisak Pholtawornkulchai

Keyword(s):

Cohort Study ◽

Hiv Infection ◽

Treatment Outcomes ◽

Successful Treatment ◽

Tuberculous Meningitis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Final Diagnosis ◽

Hiv Positive ◽

Adult Age

To compare the characteristics, presentation, investigations, and outcomes in tuberculous meningitis (TBM) patients with and without human immunodeficiency virus (HIV) coinfection. A retrospective cohort study was conducted on adult (age > 18 years) patients whose final diagnosis was TBM and who were treated at Vajira Hospital, Navamindradhiraj University, Thailand, between January 2005 and December 2016. A final total of 174 individuals were included in the study. Of these, 97 (55.75%) were HIV positive. Treatment was successful in 53 (30.5%) individuals. In HIV-infected TBM patients, there were higher proportions of patients who were younger in age (≤40 years), patients with a low body mass index, history of previous tuberculosis infection, or hepatitis C virus coinfection. A successful treatment outcome rate was lower in HIV-infected TBM patients than in HIV-uninfected TBM patients. Since HIV infection decreases the chance of successful treatment outcomes of TBM patients, future studies are needed to determine the clinical indicators for poorer survival outcomes in HIV-positive TBM patients.

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Outcome of tuberculous meningitis in children: the first comprehensive retrospective cohort study in Indonesia

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.15.0555 ◽

2016 ◽

Vol 20 (7) ◽

pp. 909-914 ◽

Cited By ~ 4

Author(s):

H. M. Nataprawira ◽

V. Ruslianti ◽

P. Solek ◽

D. Hawani ◽

M. Milanti ◽

...

Keyword(s):

Cohort Study ◽

Tuberculous Meningitis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Meningitis In Children

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Complications of tuberculous meningitis and their effect on outcome in a tertiary care cohort

The International Journal of Tuberculosis and Lung Disease ◽

10.5588/ijtld.20.0036 ◽

2020 ◽

Vol 24 (11) ◽

pp. 1194-1199 ◽

Cited By ~ 1

Author(s):

U. K. Misra ◽

J. Kalita ◽

M. Kumar ◽

A. Tripathi ◽

P. Mishra

Keyword(s):

Mechanical Ventilation ◽

Cohort Study ◽

Status Epilepticus ◽

Tuberculous Meningitis ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Stage I ◽

Drug Induced ◽

Clinical Worsening

BACKGROUND: To report the frequency and severity of complications, and their effect on the outcome of tuberculous meningitis (TBM).METHODS: In this retrospective cohort study, the following TBM complications were observed: status epilepticus (SE), hydrocephalus, paradoxical clinical worsening (PCW), hyponatremia, drug-induced hepatitis (DIH), infarction and mechanical ventilation (MV). These were recorded and correlated with stage of meningitis and outcome.RESULTS: A total of 144 patients with TBM (median age 26 years, range 12–75) were included. There were 76 (52.8%) females. The patients were in Stage I (n = 33), Stage II (n = 82) and Stage III (n = 29); 58 had definite TBM. Complications occurred in 128 (88.9%); complications included hydrocephalus (n = 58, 40.3%), hyponatremia (n = 70, 48.6%), infarction (n = 48, 33.3%), DIH (n = 42, 29.2%), SE (n = 16, 18.0%), MV (n = 43, 29.9%) and PCW (n = 24, 16.7%), with variable overlap. By 6 months, 33 patients had died. Death was related to PCW (P = 0.016), hyponatremia (P = 0.03), MV (P = 0.02), infarction (P = 0.03) and the number of complications. Except PCW, most complications occurred during the first month.CONCLUSIONS: In TBM, complications occurred in 128 (88.9%) patients, mainly in the early stages, with variable overlap. Infarction, PCW, hyponatremia and MV were predictive of poor outcome.

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