Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children
Purpose This study aimed to determine the clinicoepidemiological profile and prognostic factors in children with neurotuberculosis. Methods An observational study was conducted at a tertiary care hospital on 50 children diagnosed with neurotuberculosis. The demographic profile, clinical details, and...
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| Format: | Article |
| Language: | English |
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Korean Child Neurology Society
2023-04-01
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| Series: | Annals of Child Neurology |
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| Online Access: | http://www.annchildneurol.org/upload/pdf/acn-2022-00409.pdf |
| _version_ | 1797821933526450176 |
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| author | Vikas Sharma Krishnan Rajeshwari Deepak Kumar Garima Gupta |
| author_facet | Vikas Sharma Krishnan Rajeshwari Deepak Kumar Garima Gupta |
| author_sort | Vikas Sharma |
| collection | DOAJ |
| description | Purpose This study aimed to determine the clinicoepidemiological profile and prognostic factors in children with neurotuberculosis. Methods An observational study was conducted at a tertiary care hospital on 50 children diagnosed with neurotuberculosis. The demographic profile, clinical details, and all investigations were recorded on a predetermined form and datasheet for analysis, and disability severity was graded using the modified Rankin Scale. Results Fifty patients were enrolled (male-to-female ratio, 1.08:1). Younger children (1 to 3 years) were more commonly affected. Most patients were malnourished, and only 58% had been immunized with the Bacillus Calmette-Guerin vaccine. Fever was the most common symptom (96%) followed by headache, altered consciousness, vomiting, seizures, and abnormal posture. On cerebrospinal fluid (CSF) analysis, 87% of patients showed pleocytosis with lymphocytic predominance. More than 80% of patients had CSF protein levels >100 mg/dL and CSF glucose levels <60 mg/dL. Common findings on neuroimaging were hydrocephalus (76%), basal meningeal enhancement (60%), basal exudates (52%), and parenchymal infarcts (32%). We noted a mortality rate of 40%, of whom 87.5% had modified British Medical Research Council (BMRC) stage 3 tubercular meningitis (TBM). All patients who survived stage 3 TBM had a severe disability, and over 50% of patients with stage 2 TBM had moderate to severe disabilities. Conclusion Young age, lower socioeconomic status, BMRC stages 2 and 3, abnormal posture, hydrocephalus, and the presence of basal exudates were associated with poor outcomes. High suspicion is needed for early diagnosis and prevention of disability and mortality. |
| first_indexed | 2024-03-13T10:01:30Z |
| format | Article |
| id | doaj.art-a5df6f5281b34b7bb3ecadff79cab4f4 |
| institution | Directory Open Access Journal |
| issn | 2635-909X 2635-9103 |
| language | English |
| last_indexed | 2024-03-13T10:01:30Z |
| publishDate | 2023-04-01 |
| publisher | Korean Child Neurology Society |
| record_format | Article |
| series | Annals of Child Neurology |
| spelling | doaj.art-a5df6f5281b34b7bb3ecadff79cab4f42023-05-23T05:44:16ZengKorean Child Neurology SocietyAnnals of Child Neurology2635-909X2635-91032023-04-0131210311210.26815/acn.2022.004091314Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in ChildrenVikas Sharma0Krishnan Rajeshwari1Deepak Kumar2Garima Gupta3 Department of Pediatrics, Lok Nayak & Associated Hospitals, Maulana Azad Medical College, New Delhi, India Department of Pediatrics, Lok Nayak & Associated Hospitals, Maulana Azad Medical College, New Delhi, India Department of Pediatrics, Lok Nayak & Associated Hospitals, Maulana Azad Medical College, New Delhi, India Department of Pediatrics, ESIC Hospital Rohini, New Delhi, IndiaPurpose This study aimed to determine the clinicoepidemiological profile and prognostic factors in children with neurotuberculosis. Methods An observational study was conducted at a tertiary care hospital on 50 children diagnosed with neurotuberculosis. The demographic profile, clinical details, and all investigations were recorded on a predetermined form and datasheet for analysis, and disability severity was graded using the modified Rankin Scale. Results Fifty patients were enrolled (male-to-female ratio, 1.08:1). Younger children (1 to 3 years) were more commonly affected. Most patients were malnourished, and only 58% had been immunized with the Bacillus Calmette-Guerin vaccine. Fever was the most common symptom (96%) followed by headache, altered consciousness, vomiting, seizures, and abnormal posture. On cerebrospinal fluid (CSF) analysis, 87% of patients showed pleocytosis with lymphocytic predominance. More than 80% of patients had CSF protein levels >100 mg/dL and CSF glucose levels <60 mg/dL. Common findings on neuroimaging were hydrocephalus (76%), basal meningeal enhancement (60%), basal exudates (52%), and parenchymal infarcts (32%). We noted a mortality rate of 40%, of whom 87.5% had modified British Medical Research Council (BMRC) stage 3 tubercular meningitis (TBM). All patients who survived stage 3 TBM had a severe disability, and over 50% of patients with stage 2 TBM had moderate to severe disabilities. Conclusion Young age, lower socioeconomic status, BMRC stages 2 and 3, abnormal posture, hydrocephalus, and the presence of basal exudates were associated with poor outcomes. High suspicion is needed for early diagnosis and prevention of disability and mortality.http://www.annchildneurol.org/upload/pdf/acn-2022-00409.pdftuberculosis, meningealneuroimagingcerebrospinal fluidssocioeconomic factorsprognosis |
| spellingShingle | Vikas Sharma Krishnan Rajeshwari Deepak Kumar Garima Gupta Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children Annals of Child Neurology tuberculosis, meningeal neuroimaging cerebrospinal fluids socioeconomic factors prognosis |
| title | Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children |
| title_full | Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children |
| title_fullStr | Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children |
| title_full_unstemmed | Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children |
| title_short | Clinicoepidemiological Profile and Prognostic Factors in Neurotuberculosis in Children |
| title_sort | clinicoepidemiological profile and prognostic factors in neurotuberculosis in children |
| topic | tuberculosis, meningeal neuroimaging cerebrospinal fluids socioeconomic factors prognosis |
| url | http://www.annchildneurol.org/upload/pdf/acn-2022-00409.pdf |
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