scholarly journals TUBERCULOUS MENINGITIS;

2017 ◽  
Vol 24 (06) ◽  
pp. 865-868
Author(s):  
Sabir Ali ◽  
Adil Mahmood ◽  
Muhammad Fayyaz ◽  
Faiza Naseem
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Neurological Deficits ◽  
Significant Morbidity ◽  
Mortality And Morbidity ◽  
Clinical Criteria ◽  
Cerebrospinal Fluid Examination ◽  
The Mean ◽  
Cns Tuberculosis

Background: Central nervous system (CNS) tuberculosis constitutes 6% of alltuberculosis cases and tuberculous meningitis (TBM) is the most serious manifestation. Despiteeffective anti-tuberculous medicines, 20-50% of tuberculous patients die and significant numberof patients have neurological deficits. Failure to initiate anti-tuberculous therapy in the earlystages of the disease may lead to significant morbidity and mortality. Setting: MW-1, MW-III andMW-IV of Bahawal Victoria hospital Bahawalpur. Methods: All patients of tuberculous meningitisdiagnosed on the basis of the clinical criteria and cerebrospinal fluid examination (WBC ≥15,predominant lymphocytes and sugar level ≤40 mg/dl) were included in the study. Age, gender,and GCS level of the patients were recorded. Every patient was observed for mortality withintwo weeks after admission (within ward or enquired on mobile phone if patient was dischargedearly). Results: A total of 73 patients were included in the study. The mean age of patientswas 36.71 years with standard deviation of 17.161 years. Out of 73 patients, 31 (42.47%)patients were male and 42 (57.53%) were female. Out of 73 patients, 12 (16.44%) patients oftuberculous meningitis had mortality while 61 (83.56%) patients had no mortality. Conclusion:Tuberculous meningitis is a chronic illness with relatively high mortality and morbidity. Low levelof consciousness on admission to hospital is an important predictor for mortality.

Primary Leptomeningeal Gliomatosis in Children and Adults: A Morphological and Molecular Comparative Study With Literature Review

Neurosurgery ◽  
2015 ◽  
Vol 78 (3) ◽  
pp. 343-352 ◽  
Author(s):  
Arnault Tauziede-Espariat ◽  
Andre Maues de Paula ◽  
Melanie Pages ◽  
Annie Laquerriere ◽  
Emilie Caietta ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Overall Survival ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Clinical Symptoms ◽  
Malignant Gliomas ◽  
Leptomeningeal Gliomatosis ◽  
Molecular Features ◽  
The Central Nervous System ◽  
The Mean

Abstract BACKGROUND: Primary leptomeningeal gliomatosis (PLG) is a poorly recognized tumor of the central nervous system. OBJECTIVE: To describe the histopathological, immunohistochemical, and molecular features of PLG. METHODS: Results of our multicentric retrospective study of 6 PLG cases (3 pediatric and 3 adult) were compared with literature data. RESULTS: The mean age was 54.7 years for adults and 8.7 years for children, with 3 males and 3 females. Clinical symptoms were nonspecific. Cerebrospinal fluid analyses showed a high protein level often associated with pleocytosis but without neoplastic cells. On neuroimaging, diffuse leptomeningeal enhancement and hydrocephalus were observed, except in 1 case. PLG was mostly misinterpreted as infectious or tumoral meningitis. The first biopsy was negative in 50% of cases. Histopathologically, PLG cases corresponded to 1 oligodendroglioma without 1p19q codeletion and 5 astrocytomas without expression of p53. No immunostaining for IDH1R132H and no mutations of IDH1/2 and H3F3A genes were found. Overall survival was highly variable (2-82 months) but seems to be increased in children treated with chemotherapy. CONCLUSION: This study shows the difficulties of PLG diagnosis. The challenge is to achieve an early biopsy to establish a diagnosis and to begin a treatment, but the prognosis remains poor. PLG seems to have a different molecular and immunohistochemical pattern compared with intraparenchymal malignant gliomas.

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

2017 ◽  
Vol 4 (2) ◽  
pp. 411
Author(s):  
T. Hima Bindu ◽  
R. Maheshwara Reddy
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Tuberculous Meningitis ◽  
Mean Value ◽  
Successful Outcome ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Adenosine Deaminase Activity ◽  
The Mean ◽  
Meningitis In Children

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.

scholarly journals Cerebrospinal Fluid Sterilization with Intrathecal Polymyxin in Addition to Parenteral Polymyxin in Nosocomial Acinetobacter Meningitis

2021 ◽  
Vol 15 (7) ◽  
pp. 1550-1552
Author(s):  
Sadia Ishaque ◽  
Ehsan Bari ◽  
Muhammad Shahzad Shamim ◽  
Syed Faisal Mahmood
Keyword(s):  
Cerebrospinal Fluid ◽  
Primary Outcome ◽  
Complete Recovery ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Neurological Deficits ◽  
Intrathecal Therapy ◽  
Acinetobacter Species ◽  
Nosocomial Meningitis ◽  
The Mean

Background: For the last few decades there has been a substantial concern regarding the increasing prevalence of multidrug resistant (MDR) Acinetobacter species in hospitals. Aim: To determine the outcomes with intrathecal polymyxins therapy in patients with multidrug resistant Acinetobacter species nosocomial meningitis. Place and duration of study: This Retrospective study was conducted in the Department of Infectious Diseases, Aga Khan University Hospital, Karachi Pakistan between 2010 and 2014. Methodology: Twenty six patients who developed post neurosurgical MDR Acinetobacter nosocomial meningitis age above 18 were included, while those with polymicrobial meningitis, and those patients who only received intravenous polymyxins were excluded. The primary outcome is ability and time to sterilize the cerebrospinal fluid Results: The mean age was 42.9±11.5 years. Cerebrospinal fluid sterilization was observed in 24 patients in a median of 4 days. One patient made complete recovery, 16 patients recovered with neurological deficits and five patients expired. A trend of early cerebrospinal fluid sterilization was observed in patients with continuous intrathecal therapy. The time to cerebrospinal fluid sterilization is similar with intrathecal colistin or polymyxin. Conclusion: Intrathecal polymyxins are safe and efficacious in the treatment of multidrug resistant nosocomial Acinetobacter species meningitis. Keywords: Intrathecal, Polymyxins, Multidrug resistant, Acinetobacter species, Nosocomial, Meningitis

Nervous System Lyme Disease

2017 ◽  
Author(s):  
John J. Halperin
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Clinical Manifestations ◽  
Cerebrospinal Fluid Examination ◽  
The Central Nervous System ◽  
Cranial Neuropathies ◽  
Lymphocytic Meningitis

Nervous system involvement occurs in 10% to 15% of patients infected with Borrelia burgdorferi, B. afzelii, or B. garinii, the tick-borne spirochetes responsible for Lyme disease and its European counterparts. Common clinical manifestations include lymphocytic meningitis, facial and other cranial neuropathies, and painful mononeuropathies such as Lyme radiculitis. Diagnosis requires appropriate clinical, epidemiological, and laboratory evidence. Appropriately interpreted serologic testing is highly reliable; cerebrospinal fluid examination is often informative if the central nervous system is involved. Several week courses of widely available oral or parenteral antimicrobials are curative in most patients.

scholarly journals Clinical and Laboratory Findings That Differentiate Herpes Simplex Virus Central Nervous System Disease from Enteroviral Meningitis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Layli Sanaee ◽  
Monica Taljaard ◽  
Tim Karnauchow ◽  
Jeffrey J. Perry
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Mental Status ◽  
Altered Mental Status ◽  
Neurological Deficits ◽  
Simplex Virus ◽  
Csf Findings

Background. It can be difficult for clinicians to distinguish between the relatively benign enteroviral (EnV) meningitis and potentially lethal herpes simplex virus (HSV) central nervous system (CNS) disease. Very limited evidence currently exists to guide them.Objective. This study sought to identify clinical features and cerebrospinal fluid (CSF) findings associated with HSV CNS disease.Methods. Given that PCR testing often is not immediately available, this chart review study sought to identify clinical and cerebrospinal fluid (CSF) findings associated with HSV meningitis over a 6-year period. In cases where PCR was not performed, HSV and EnV were assigned based on clinical criteria.Results. We enrolled 166 consecutive patients: 40 HSV and 126 EnV patients. HSV patients had a mean 40.4 versus 31.3 years for EnV,p=0.005, seizures 21.1% versus 1.6% for EnV,p<0.001, altered mental status 46.2% versus 3.2% for EnV,p<0.001, or neurological deficits 44.7% versus 3.9% for EnV,p<0.001. CSF neutrophils were lower in HSV (median 3.0% versus 9.5%,p=0.0002); median lymphocytes (87.0% versus 67.0%,p=0.0004) and protein (0.9 g/L versus 0.6 g/L,p=0.0005) were elevated.Conclusion. Our study found that HSV patients were older and more likely to have seizure, altered mental status, or neurological deficits than patients with benign EnV meningitis. HSV cases had lower CSF neutrophils, higher lymphocytes, and higher protein levels.

Characteristics of cerebrospinal fluid under tuberculosis in patients with HIV-infection

2021 ◽  
Vol 13 (1) ◽  
pp. 53-58
Author(s):  
A. M. Panteleev ◽  
O. S. Sokolova ◽  
A. V. Zonova ◽  
S. A. Panteleeva ◽  
A. V. Lutsenko
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Brain Injury ◽  
Hiv Infection ◽  
Protein Level ◽  
Saint Petersburg ◽  
Laboratory Changes ◽  
Cns Tuberculosis ◽  
Cd4 Lymphocytes

Purpose. To carry out an analysis of characteristics and to reveal the peculiarities of laboratory changes of cerebrospinal fluid (CSF) in patients with tuberculosis of central nervous system associated with HIV-infection.Materials and methods. Analysis of 206 patients with CNS tuberculosis associated with HIV-infection who were treated in State Budgetary Healthcare Institution «City tuberculosis hospital No. 2» of Saint Petersburg during the period from 2006 to 2018 was conducted.Results and discussion. It was concluded that a mean protein level in CSF was 1,6±0,1 g/l and was significantly increased in patients with tubercular meningoencephalomyelitis. When decreasing the amount of CD4-lymphocytes, increasing of protein level in cerebrospinal fluid is observed. As cytosis increases, the amount of neutrophils increases too. Patients with tuberculous meningitis showed remarkable pleocytosis in comparison with patients with meningocephalitis. In 47% of cases, neutrophilic cell composition of CSF was registered. Therewith, the rate of neutrophils in CSF increased as the rate of lymphocytes decreased. Reducing of glucose in CSF was observed in the majority of patients with CNS tuberculosis independently of severity of immunosuppression and extent of brain injury.

scholarly journals Presentation and outcome of tuberculous meningitis in adults in the province of Castellon, Spain: a retrospective study

2008 ◽  
Vol 136 (11) ◽  
pp. 1455-1462 ◽  
Author(s):  
B. ROCA ◽  
N. TORNADOR ◽  
E. TORNADOR
Keyword(s):  
Cerebrospinal Fluid ◽  
Serum Cholesterol ◽  
Tuberculous Meningitis ◽  
Clinical Presentation ◽  
Imaging Study ◽  
Common Symptom ◽  
Significant Morbidity ◽  
Sociodemographic Data ◽  
Nuchal Rigidity ◽  
Study Results

SUMMARYThe aim of this study was to describe the epidemiological and clinical features of tuberculous meningitis in the province of Castellon, Spain. Retrospective analysis was done of all cases attended during the last 15 years. The following groups of variables were assessed: sociodemographic data, medical antecedents, clinical presentation, imaging study results, analyses, cerebrospinal fluid microbiology, treatment, and outcome. Twenty-nine cases were included. Median of age of patients was 34 years, and 17 (59%) were males. HIV infection was present in 15 cases (52%), fever, the most common symptom, occurred in 27 (93%), nuchal rigidity was noted in only 16 (55%), and syndrome of inappropriate ADH secretion (SIADH) occurred in 13 cases (45%). Chest radiograph was abnormal in 15 cases (52%). Anaemia was found in 22 subjects (76%), hypoalbuminaemia in 18 (62%) and hyponatraemia in 15 (52%). Macroscopic aspect of cerebrospinal fluid was normal in 17 cases (65%). Acid-fast stain was positive in only one case (4%). Two patients presented resistance to anti-tuberculous medications. Twelve patients (41%) died and eight (28%) presented sequelae. An association was found between death as outcome and presence of SIADH and lower level of serum cholesterol. Tuberculous meningitis is a rare and frequently difficult to recognize disease, which results in significant morbidity and mortality. We found an association of mortality with SIADH and lower level of serum cholesterol.

scholarly journals Tuberculous meningitis – clinical and laboratory review of 100 patients

1986 ◽  
Vol 96 (2) ◽  
pp. 231-238 ◽  
Author(s):  
M. E. Kilpatrick ◽  
N. I. Girgis ◽  
M. W. Yassin ◽  
A. A. Abu El Ella
Keyword(s):  
Central Nervous System ◽  
Tuberculous Meningitis ◽  
Clinical Course ◽  
Laboratory Data ◽  
Severity Of Illness ◽  
X Rays ◽  
Antituberculous Therapy ◽  
Mortality And Morbidity ◽  
Neurologic Sequelae ◽  
Physical Findings

SUMMARYIn developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).

Sign in / Sign up

Export Citation Format

Share Document