Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis.
Tuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae.Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing cou...
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4506084?pdf=render |
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| author | Egidia G Miftode Olivia S Dorneanu Daniela A Leca Gabriela Juganariu Andra Teodor Mihnea Hurmuzache Eduard V Nastase Dana T Anton-Paduraru |
| author_facet | Egidia G Miftode Olivia S Dorneanu Daniela A Leca Gabriela Juganariu Andra Teodor Mihnea Hurmuzache Eduard V Nastase Dana T Anton-Paduraru |
| author_sort | Egidia G Miftode |
| collection | DOAJ |
| description | Tuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae.Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing countries.We performed a retrospective analysis of the 127 adult and 77 pediatric cases diagnosed with TBM in the Infectious Disease Hospital of the School of Medicine of Iasi, Romania between 2004-2013.Definite diagnosis of TBM was established in 31% of children but in only 20% of adults (p = 0.043). A contact with an individual with pulmonary tuberculosis was documented in 30% of children vs. 13% of adults (p = 0.0007). Coma occurred in 19% of patients (similar in children and adults); other consciousness abnormalities were seen in 27% of children and in 72% of adults (p = 0.000001). Cranial nerve palsies occurred prior to therapy in 9% of cases (12% vs 7% of children and adults, respectively, p>0.05), and developed 2-7 days after treatment initiation in 10% (12 vs 9%). CSF cultures were positive for M. tuberculosis in 24% of patients (31% vs. 20%, p>0.05). Overall mortality was 7.35%, similar for children and adults. Yet, permanent neurological sequelae, which were seen in 23% of patients occurred significantly more frequent in children vs. adults (36% vs. 14%, respectively, p = 0.0121). In conclusion, our retrospective analysis on a significant number of cases of TBM identified striking differences between children and adults: while children were in an earlier stage at the admission, they associated a higher frequency of neurological sequelae and miliary pattern, and they were more likely to have normal CSF protein levels and positive cultures of CSF. |
| first_indexed | 2024-12-20T04:51:10Z |
| format | Article |
| id | doaj.art-a195a6f4d5124671a65c4ec2dc0594e9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-20T04:51:10Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a195a6f4d5124671a65c4ec2dc0594e92022-12-21T19:52:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01107e013347710.1371/journal.pone.0133477Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis.Egidia G MiftodeOlivia S DorneanuDaniela A LecaGabriela JuganariuAndra TeodorMihnea HurmuzacheEduard V NastaseDana T Anton-PaduraruTuberculous meningitis (TBM) is the most lethal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae.Our study offers a real-world infectious disease clinic perspective, being thus representative for the clinical environment of developing countries.We performed a retrospective analysis of the 127 adult and 77 pediatric cases diagnosed with TBM in the Infectious Disease Hospital of the School of Medicine of Iasi, Romania between 2004-2013.Definite diagnosis of TBM was established in 31% of children but in only 20% of adults (p = 0.043). A contact with an individual with pulmonary tuberculosis was documented in 30% of children vs. 13% of adults (p = 0.0007). Coma occurred in 19% of patients (similar in children and adults); other consciousness abnormalities were seen in 27% of children and in 72% of adults (p = 0.000001). Cranial nerve palsies occurred prior to therapy in 9% of cases (12% vs 7% of children and adults, respectively, p>0.05), and developed 2-7 days after treatment initiation in 10% (12 vs 9%). CSF cultures were positive for M. tuberculosis in 24% of patients (31% vs. 20%, p>0.05). Overall mortality was 7.35%, similar for children and adults. Yet, permanent neurological sequelae, which were seen in 23% of patients occurred significantly more frequent in children vs. adults (36% vs. 14%, respectively, p = 0.0121). In conclusion, our retrospective analysis on a significant number of cases of TBM identified striking differences between children and adults: while children were in an earlier stage at the admission, they associated a higher frequency of neurological sequelae and miliary pattern, and they were more likely to have normal CSF protein levels and positive cultures of CSF.http://europepmc.org/articles/PMC4506084?pdf=render |
| spellingShingle | Egidia G Miftode Olivia S Dorneanu Daniela A Leca Gabriela Juganariu Andra Teodor Mihnea Hurmuzache Eduard V Nastase Dana T Anton-Paduraru Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. PLoS ONE |
| title | Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. |
| title_full | Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. |
| title_fullStr | Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. |
| title_full_unstemmed | Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. |
| title_short | Tuberculous Meningitis in Children and Adults: A 10-Year Retrospective Comparative Analysis. |
| title_sort | tuberculous meningitis in children and adults a 10 year retrospective comparative analysis |
| url | http://europepmc.org/articles/PMC4506084?pdf=render |
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