Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study
Abstract Background Central nervous system tuberculosis (CNS TB) is a severe Mycobacterium tuberculosis (MTB) infection. It is unclear whether a patient’s immune status alters the clinical manifestations and treatment outcomes of CNS TB. Methods Between January 2007–December 2018, chart reviews of C...
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Annals of Clinical Microbiology and Antimicrobials |
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| Online Access: | https://doi.org/10.1186/s12941-023-00615-w |
| _version_ | 1797453622198403072 |
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| author | Woraseth Saifon Khemajira Karaketklang Anupop Jitmuang |
| author_facet | Woraseth Saifon Khemajira Karaketklang Anupop Jitmuang |
| author_sort | Woraseth Saifon |
| collection | DOAJ |
| description | Abstract Background Central nervous system tuberculosis (CNS TB) is a severe Mycobacterium tuberculosis (MTB) infection. It is unclear whether a patient’s immune status alters the clinical manifestations and treatment outcomes of CNS TB. Methods Between January 2007–December 2018, chart reviews of CNS TB, including tuberculous meningitis (TBM), tuberculoma/abscess, and TB myelitis, were made. Subjects were categorized as immunodeficient (ID) and non-immunodeficient (NID). Results Of 310 subjects, 160 (51.6%) were in the ID group—132 (42.6%) had HIV and 28 (9.0%) had another ID, and 150 (48.4%) were in the NID group. The mean age was 43.64 ± 16.76 years, and 188 (60.6%) were male. There were 285 (91.9%) TBM, 16 (5.2%) tuberculoma/abscess, and 9 (2.9%) myelitis cases. The TBM characteristics in the ID group were younger age (p = 0.003), deep subcortical location of tuberculoma (p = 0.030), lower hemoglobin level (p < 0.001), and lower peripheral white blood cell count (p < 0.001). Only HIV individuals with TBM had an infection by multidrug-resistant MTB (p = 0.013). TBM mortality was varied by immune status —HIV 22.8%, other ID 29.6%, and NID 14.8% (p < 0.001). Factors significantly associated with unfavorable outcomes in TBM also differed between the HIV and NID groups. Conclusions TBM is the most significant proportion of CNS TB. Some of the clinical characteristics of TBM, such as age, radiographic findings, hematological derangement, and mortality, including factors associated with unfavorable outcomes, differed between ID and non-ID patients. |
| first_indexed | 2024-03-09T15:25:29Z |
| format | Article |
| id | doaj.art-9a6ef810a3be48a490e7657b71177fe9 |
| institution | Directory Open Access Journal |
| issn | 1476-0711 |
| language | English |
| last_indexed | 2024-03-09T15:25:29Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj.art-9a6ef810a3be48a490e7657b71177fe92023-11-26T12:34:47ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112023-08-0122111410.1186/s12941-023-00615-wDistinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective studyWoraseth Saifon0Khemajira Karaketklang1Anupop Jitmuang2Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDepartment of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract Background Central nervous system tuberculosis (CNS TB) is a severe Mycobacterium tuberculosis (MTB) infection. It is unclear whether a patient’s immune status alters the clinical manifestations and treatment outcomes of CNS TB. Methods Between January 2007–December 2018, chart reviews of CNS TB, including tuberculous meningitis (TBM), tuberculoma/abscess, and TB myelitis, were made. Subjects were categorized as immunodeficient (ID) and non-immunodeficient (NID). Results Of 310 subjects, 160 (51.6%) were in the ID group—132 (42.6%) had HIV and 28 (9.0%) had another ID, and 150 (48.4%) were in the NID group. The mean age was 43.64 ± 16.76 years, and 188 (60.6%) were male. There were 285 (91.9%) TBM, 16 (5.2%) tuberculoma/abscess, and 9 (2.9%) myelitis cases. The TBM characteristics in the ID group were younger age (p = 0.003), deep subcortical location of tuberculoma (p = 0.030), lower hemoglobin level (p < 0.001), and lower peripheral white blood cell count (p < 0.001). Only HIV individuals with TBM had an infection by multidrug-resistant MTB (p = 0.013). TBM mortality was varied by immune status —HIV 22.8%, other ID 29.6%, and NID 14.8% (p < 0.001). Factors significantly associated with unfavorable outcomes in TBM also differed between the HIV and NID groups. Conclusions TBM is the most significant proportion of CNS TB. Some of the clinical characteristics of TBM, such as age, radiographic findings, hematological derangement, and mortality, including factors associated with unfavorable outcomes, differed between ID and non-ID patients.https://doi.org/10.1186/s12941-023-00615-wCentral nervous systemImmunodeficiencyMeningitisMycobacterium tuberculosisTuberculosis |
| spellingShingle | Woraseth Saifon Khemajira Karaketklang Anupop Jitmuang Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study Annals of Clinical Microbiology and Antimicrobials Central nervous system Immunodeficiency Meningitis Mycobacterium tuberculosis Tuberculosis |
| title | Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study |
| title_full | Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study |
| title_fullStr | Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study |
| title_full_unstemmed | Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study |
| title_short | Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study |
| title_sort | distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non immunodeficient individuals a 12 year retrospective study |
| topic | Central nervous system Immunodeficiency Meningitis Mycobacterium tuberculosis Tuberculosis |
| url | https://doi.org/10.1186/s12941-023-00615-w |
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