Management of complex tuberculosis cases: a focus on drug-resistant tuberculous meningitis

Garg, Ravindra Kumar; Rizvi, Imran; Malhotra, Hardeep Singh; Uniyal, Ravi; Kumar, Neeraj

doi:10.1080/14787210.2018.1540930

Cited by 22 publications

(14 citation statements)

References 108 publications

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“…On the other hand, our series' data does not show susceptibility issues to first-line TB drugs. However, it is an emerging problem, so it is necessary to be aware of the possibility that these resistant strains may be involved in cases of TBM (Garg et al, 2018). The optimal antimicrobial treatment regimen for TBM has not been well established in clinical trials (Ruslami et al, 2013;Heemskerk et al, 2016), and current guidelines are extrapolated from treatment regimens for pulmonary tuberculosis (Anon, 2016;Lewinsohn et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Forty years of Tuberculous meningitis: The new face of an old enemy

García-Caballero

Francisco

Martínez-García

et al. 2020

International Journal of Infectious Diseases

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Background: Tuberculous meningitis (TBM) occurs in 1-5% of cases of tuberculosis. Without early treatment, mortality and permanent disability rates are high. Methods: A retrospective study performed at a tertiary hospital in Madrid (Spain) to describe clinical, diagnostic, and therapeutic aspects of TBM and analyze epidemiological trends over forty years, divided into two intervals (1979À1998 and 1999À2018). Results: Overall, TBM was diagnosed in 65 patients (1.8% of new tuberculosis diagnoses), 48 in the first period and 17 in the second one. Median age at diagnosis increased from 38.5 to 77 years (p = 0.003). The proportion of non-HIV immunosuppressed patients increased (from 2.1% to 29.4%, p < 0.001), while the percentage of patients with a history of drug-abuse decreased (from 33.3% to 5.9%, p = 0.027). The median time between the onset of neurological symptoms and lumbar puncture increased from seven to 15 days (p = 0.040). The time between the onset of symptoms and the initiation of tuberculostatic treatment also increased from eleven to 18 days (p = 0.555). Results from image, biochemical, and microbiological tests showed no differences between both periods. A decreasing trend was observed in survival rates at 1week (from 97.9% to 64.7%, p < 0.001), 1-month (from 91.7% to 58.8%, p = 0.002) and 1-year (from 85.4% to 47.1%, p = 0.002) after TBM diagnosis. Conclusions: The profile of patients diagnosed with TBM has changed from a young HIV-infected patient with a history of drug addiction to an elderly patient with non-HIV immunosuppression. Diagnosis and start of treatment both experienced a noticeable delay in the second period, which could help explain the increase in mortality observed across the two periods.

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Section: Discussionmentioning

confidence: 99%

Forty years of Tuberculous meningitis: The new face of an old enemy

García-Caballero

Francisco

Martínez-García

et al. 2020

International Journal of Infectious Diseases

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“…The priority population for testing and preventive therapy for latent infection is household contact of TB patients who are likely to be infected by their household members. However, in settings where the incidence of new is high, infections also frequently occurs outside the home [24,25].…”

Section: Risk Of Developing Tb Over a Lifetimementioning

confidence: 99%

An Overview on Tuberculosis and Worldwide Steps to Combat TB Including Awareness Programme in India

Bhoyar

Veena

Chandrakantsing

et al. 2021

JPRI

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Objectives of current review is to collate history of Tuberculosis (TB), overview of the current literature on epidemiology, world health organisations (WHO) recent strategic plan to overcome and eliminate TB from the root, and to determine current knowledge gaps for control of TB. This study is a review, a descriptive approach of state-of-science for better treatment strategies for TB. The article finds that to reach to end TB goal, WHO, we have to follow the guideline of who about TB control, along with that the Indian government also maintained awareness program. Current findings on TB suggest that with the development of science and technology, researches being conducted to minimise the drug resistance tuberculosis, as well as WHO sets new strategy to fight against TB, which could potentially change the casual outlook of the people towards their health habits, health issues, and will help them in future to tackle from this deadly killer disease.

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“…28 While there have been no randomized controlled trials for treatment of multidrug-resistant CNS tuberculosis, an alternative regimen that can be considered after treatment failure or detection of a resistant strain includes levofloxacin, kanamycin, ethionamide, linezolid, and pyrazinamide. 29…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

Pharmacologic Treatment of Meningitis and Encephalitis in Adult Patients

Treister

Koerner

2019

Journal of Neuroanaesthesiology and Critical Care

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Meningitis and encephalitis are two inflammatory, often infectious, disorders of the meninges and the central nervous system. Both are associated with significant morbidity and mortality, and require early and aggressive targeted treatment. This article reviews pharmacologic treatment strategies for infectious meningitis and encephalitis, using the latest available research and guidelines. It provides an overview of empiric antimicrobial treatment approaches for a variety of organisms, including a discussion of trends in antibiotic resistance where applicable. Key steps in diagnosis and general management are briefly reviewed.

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Management of complex tuberculosis cases: a focus on drug-resistant tuberculous meningitis

Cited by 22 publications

References 108 publications

Forty years of Tuberculous meningitis: The new face of an old enemy

Forty years of Tuberculous meningitis: The new face of an old enemy

An Overview on Tuberculosis and Worldwide Steps to Combat TB Including Awareness Programme in India

Pharmacologic Treatment of Meningitis and Encephalitis in Adult Patients

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