A diagnostic rule for tuberculous meningitis

Abstract

(Arch Dis Child 1999;81:221-224)

A New Diagnostic Scoring for Discrimination of Tuberculous and Bacterial Meningitis on the Basis of Clinical and Laboratory Findings

“…(1) TM: Mycobacterium tuberculosis isolated from CSF or clinical meningitis with negative Gram stain and sterile bacterial and fungal cultures plus one or more of the following: (a) cranial tomographic or cranial magnetic resonance image consistent with tuberculoma or hydrocephalus, (b) chest radiograph or chest CT consistent with miliary or active tuberculosis, and (c) good response to antituberculous treatment [1,10]. (2) BM: A pathogenic bacteria isolated from CSF or clinical signs and symptoms of meningitis with pleocytosis in CSF and blood culture yielding a bacteria or Gram stain of CSF demonstrated a bacteriologic agent [10,11].…”

“…Meningitis is a critical disease that needs rapid diagnosis and initiation of appropriate early treatment, otherwise it could lead to permanent disabilities or death, since there is a high rate of mortality for meningitis [1,2,3]. Laboratory tests usually lack the power to discriminate between bacterial meningitis (BM) and non-BM [3,4].…”

Performance of an interferon-gamma release assay in the diagnosis of tuberculous meningitis in children / Performanţa testului bazat pe eliberarea interferonului gamma în diagnosticul meningitei tuberculoase la copil

“…Tuberculous meningitis is a severe illness in children, and 61.9% of the TBM group was admitted to the hospital with coma, 69.8% with confusion and 25.4% with neurological signs (cranial nerve palsies, hemi or paraparesis). In other studies, coma has been found in 30-60% of TMB cases, seizures in 50% of children and cranial nerves palsies in 30-50% of patients [15][16][17]. Kumar analyzed the clinical and laboratory features that were predictive of tuberculous meningitis and found that history of illness >5-6 days, focal neurological deficits, abnormal movements were significantly more common in TBM patients than other meningoencephalites [16][17][18][19].…”

“…In other studies, coma has been found in 30-60% of TMB cases, seizures in 50% of children and cranial nerves palsies in 30-50% of patients [15][16][17]. Kumar analyzed the clinical and laboratory features that were predictive of tuberculous meningitis and found that history of illness >5-6 days, focal neurological deficits, abnormal movements were significantly more common in TBM patients than other meningoencephalites [16][17][18][19]. However, in our study, the onsets were frequently atypical (57% of patients) and manifested as digestive disorders or prolonged fever, and it was too late to seek care from infectious disease specialist in these cases.…”

Modified External Ventricular Drainage in Pediatric Tuberculous Meningitis: Is It Possible to Avoid Ventriculoperitoneal Shunt Placement?

“…It has been shown by various studies that communicating hydrocephalus is the commonest type found in TBMH, and its most common cause is exudative obstruction of the tentorial hiatus [4,23,24,25,26,27,28]. Pathologic changes diffusely affect the arachnoid membrane and subarachnoid space.…”