A Rare Presentation of Tubercular Meningitis as Persistent Neutrophilic Meningitis

Ralot, Tarun Kumar; Bafna, Chander; Singh, Surender; Sharma, Shaveta

doi:10.21315/mjms2017.24.6.13

Cited by 3 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CSF profile without lymphocyte predominated was an unusual CSF finding for TBM, which still has been puzzling in our study. Several studies reported that subacute meningitis without lymphocyte-predominant CSF might be attributable to an early onset of TBM, nocardiosis, fungal infection, enterovirus infection, and herpes virus infection [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study

Saifon

Karaketklang

Jitmuang

2023

Ann Clin Microbiol Antimicrob

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study

Saifon

Karaketklang

Jitmuang

2023

Ann Clin Microbiol Antimicrob

View full text Add to dashboard Cite

show abstract

Neurotuberculosis: an update

et al. 2021

View full text Add to dashboard Cite

Steroid-Responsive Post-Traumatic Persistent Neutrophilic Meningitis

Haddad

Sheybani

Olfati

et al. 2022

Case Reports in Medicine

View full text Add to dashboard Cite

Post-traumatic meningitis is a potentially fatal condition that presents as a diagnostic and therapeutic challenge. The vast majority of post-traumatic meningitides are caused by infectious pathogens, most commonly multi-drug-resistant (MDR) bacterial pathogens. However, aseptic meningitis occurs less frequently due to tissue response to injury or stimulation by noninfectious agents, such as blood breakdown products or chemicals. Here, we present a case of post-traumatic persistent neutrophilic meningitis who was found to be steroid responsive. Diagnostic evaluation in our patient did not reveal any infectious pathogen, and the patient did not respond to broad-spectrum antimicrobial treatment. We suggest that physicians who treat patients with post-traumatic meningitis should consider steroid-responsive post-traumatic persistent neutrophilic meningitis (SPNM) in the list of differential diagnosis particularly when no infectious etiology is found and the patient does not respond to empirical antimicrobial treatment. Brain injury-induced immune dysregulation causing exaggerated inflammatory reaction might play a role in the pathogenesis of SPNM; however, further neuropathological studies are absolutely necessary to evaluate and characterize trauma-induced immune dysregulation.

show abstract

A Rare Presentation of Tubercular Meningitis as Persistent Neutrophilic Meningitis

Cited by 3 publications

References 6 publications

Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study

Distinguishing clinical characteristics of central nervous system tuberculosis in immunodeficient and non-immunodeficient individuals: a 12-year retrospective study

Neurotuberculosis: an update

Steroid-Responsive Post-Traumatic Persistent Neutrophilic Meningitis

Contact Info

Product

Resources

About