A predictive score followed by nucleic acid amplification for adult tuberculous meningitis diagnosis in Southern Brazil

Anselmo, Lívia Maria Pala; Feliciano, Cinara Silva; Mauad, Fernando Marum; Nascimento, Margarida P.; Pocente, Renata Candido; Silva, Jorgete Maria; Bollela, Valdes Roberto

doi:10.1016/j.jns.2017.06.016

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Clinical presentation of TBM is highly pleomorphic but includes cranial nerve palsy, headache, meningeal syndrome, and mental alterations. A study carried out in Brazil in 2013, in which 300 patients were included, reported upon admission alterations in the state of consciousness in 61% (15) while in our series 16% of population had coma, this data may indicate a delay in the diagnosis due to delays in consultation.…”

Section: Discussionsupporting

confidence: 37%

Tuberculous meningitis in adult patients of a Mexican neurological referral center: A-six-year retrospective cohort study

Maldonado-Díaz¹,

Soto-Hernández²,

Salinas-Lara³

et al. 2020

Preprint

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IntroductionTuberculosis (TB) remains as an important concern of public health worldwide because the high prevalence and severe sequelae. Tuberculous meningitis (TBM) is the most lethal and disabling form.AimTo describe the clinical, laboratory, and neuroimaging characteristics of TBM on admission at neurological center in Mexico City.MethodsRetrospective cohort study at the third level neurological center from 2010 to 2016. Clinical follow-up was evaluated at hospital discharge, three months, and one-year either due to lack of follow-up or mortality, during the follow-up the adverse events were registered.ResultsOne-hundred and six patients were included, 74 (69.8%) males and 32 (30.2%) females. From these 31 (29.2%) were HIV-positive. The median age was 35.5 (IQR:28-51). Pulmonary TB was found in 25% of the population. Alcoholism was observed in a half of the patients while diabetes in 15%, the latter being significant (p=0.04). Abnormalities in neuroimaging were significant among our population (p=0.003). Only one-third of the population had a positive Lowenstein-Jensen culture. There were no differences in clinical outcomes between HIV positive and non-HIV patients.ConclusionOur study shows data to those described in the literature. The initiation of empirical treatment in all patients with a high clinical suspicion of tuberculosis mandatory to try to avoid severe neurological sequels.

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Section: Discussionsupporting

confidence: 37%

Tuberculous meningitis in adult patients of a Mexican neurological referral center: A-six-year retrospective cohort study

Maldonado-Díaz¹,

Soto-Hernández²,

Salinas-Lara³

et al. 2020

Preprint

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show abstract

“…Such scores have mainly been assessed in extra-pulmonary TB since molecular diagnosis accuracy is particularly affected by their low bacillary load. The utility of this type of score was confirmed repeatedly in TB meningitis (TBM) [41,42], and was recently included in a consensual TBM diagnosis classification [43]. An equivalent score would also be helpful for pulmonary TB; it could be based on those validated to determine the need of early respiratory isolation before M. tb isolation [44,45].…”

Section: Discussionmentioning

confidence: 99%