Presentation, etiology, and outcome of brain infections in an Indonesian hospital

Imran, Darma; Estiasari, Riwanti; Maharani, Kartika; Sucipto, Sucipto; Lestari, Delly Chipta; Yunus, Reyhan Eddy; Yunihastuti, Evy; Karyadi, Teguh Haryono; Oei, D; Timan, Ina Susianti; Wulandari, Dewi; Wahyuningsih, Retno; Adawiyah, Robiatul; Kurniawan, Agnes; Mulyadi, Rahmad; Karuniawati, Anis; Jaya, Ungke Anton; Safari, Dodi; Laarhoven, Arjan van; Alisjahbana, Bachti; Dian, Sofiati; Chaidir, Lidya; Ganiem, Ahmad Rizal; Lastri, Diatri Nari; Myint, Khin Saw Aye; Crevel, Reinout van

doi:10.1212/cpj.0000000000000517

Cited by 25 publications

(26 citation statements)

References 28 publications

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“…4 In Indonesia, TE is still the main CNS disorder in AIDS patients followed after Tuberculous meningitis. 5 A definitive diagnosis of TE can be provided by brain biopsy and finding T. gondii tachyzoites. The examination is an invasive procedure and associated with a significant increase in morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Nested PCR methods for detection Toxoplasma gondii B1 gene in Cerebrospinal Fluid of HIV patients

Halleyantoro

Andriyani

Sari

et al. 2019

J. Biomed. Transl. Res.

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Background: Toxoplasmosis is a disease caused by infection of Toxoplasma gondii, Which may cause a life-threatening condition in immunocompromised patients, for example, Toxoplasma encephalitis (TE). It is challenging to diagnose Toxoplasma as a cause of central nervous system (CNS) infection in HIV patient, so we need an alternative method, which is a PCR detection of Toxoplasma gondii B1 gene.Objective: This research aimed to find association between PCR methods for Toxoplasma gondii B1 gene and anti-Toxoplasma IgG from cerebral spinal fluid patient HIV AIDS.Methods: A cross-sectional study was conducted to Cerebrospinal fluid (CSF) samples of HIV patients with neurological symptoms to determine Toxoplasma gondii infection using nested PCR methods for the B1 gene and detection of anti-Toxoplasma IgG.Results: 88 CSF samples from HIV patients tested using nested PCR showed 23 samples (26,1%) were positive. Serologic test for IgG Toxoplasma showed 34 samples were positive (28,6%). There was a significant correlation (p=0.000(<0.05) between PCR result and a serologic test for IgG Toxoplasma.Conclusion: Nested PCR methods to detect B1 gene increased the accuracy of diagnosis for toxoplasma encephalitis.

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Section: Introductionmentioning

confidence: 99%

Nested PCR methods for detection Toxoplasma gondii B1 gene in Cerebrospinal Fluid of HIV patients

Halleyantoro

Andriyani

Sari

et al. 2019

J. Biomed. Transl. Res.

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“…Recently, Imran et al . reported that tuberculosis, toxoplasmosis, and cryptococcosis are common causes of CNS infections in adult patients in a referral hospital in Jakarta, Indonesia [ 9 ]. Therefore, this study aimed to isolate, identify and determine the serotype of S. pneumoniae strains in cerebrospinal fluid (CSF) from patients clinically diagnosed with CNS infection at a national referral hospital, Jakarta, Indonesia.…”

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confidence: 99%

Isolation and identification of Streptococcus pneumoniae serotype 6B from a patient with bacterial meningitis infection in Jakarta, Indonesia

Purwanto

Loho

Tafroji

et al. 2020

Access Microbiology

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CNS infection is a life-threatening condition in developing countries and Streptococcus pneumoniae has been reported as the most common cause of bacterial meningitis; however, there is limited data on pneumococcal meningitis in Indonesia. This cross-sectional study aimed to isolate and identity S. pneumoniae strains from cerebrospinal fluid (CSF) specimens collected as part of routine testing from patients with clinically diagnosed central nervous system infection at a national referral hospital in Jakarta, Indonesia in 2017. S. pneumoniae isolation and identification were performed using conventional culture and molecular tools. Antibiotic susceptibility patterns were monitored through minimum inhibitory concentration testing. From 147 CSF specimens, one S. pneumoniae strain was identified from a patient with bacterial meningitis symptoms. The isolate was serotype 6B (ST5661) and susceptible to 18 antimicrobial agents tested, including penicillin, tetracycline, and the macrolide group. Our data provide insights into the epidemiology of invasive pneumococcal disease in Indonesia.

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“…3 An insidious onset of non-specific prodromal symptoms followed by a slowly progressive meningitis makes diagnosis challenging, with a wide differential especially in HIV co-infection. 4 Delayed diagnosis and treatment lead to poor outcomes. 5 Inflammatory pathways are not completely understood.…”

Section: Panel 1: Pathophysiologymentioning

confidence: 99%

The neurocritical care of tuberculous meningitis

Donovan

Figaji

Imran

et al. 2019

The Lancet Neurology

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Tuberculous meningitis (TBM) is the most devastating form of tuberculosis (TB) and often causes critical illness with high mortality. A primary management objective is reducing intracranial pressure (ICP), and optimising cerebral perfusion, whilst killing the bacteria and controlling intra-cerebral inflammation. However, the evidence base guiding the care of critically ill patients with TBM is poor and many patients do not have access to neurocritical care units. Invasive ICP monitoring is often unavailable; whilst new non-invasive monitoring techniques show promise, further evidence for their use is required. Optimal management of neurological complications, and of hyponatraemia, which frequently accompanies TBM, is not known. The best supportive care remains uncertain. Recent advances in the field of TBM predominantly focus upon diagnosis, inflammatory processes and anti-TB chemotherapy. Clinical trials are required to provide robust evidence guiding the most effective supportive, therapeutic and neurosurgical interventions in TBM, with proven benefits for morbidity and mortality.

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Presentation, etiology, and outcome of brain infections in an Indonesian hospital

Cited by 25 publications

References 28 publications

Nested PCR methods for detection Toxoplasma gondii B1 gene in Cerebrospinal Fluid of HIV patients

Nested PCR methods for detection Toxoplasma gondii B1 gene in Cerebrospinal Fluid of HIV patients

Isolation and identification of Streptococcus pneumoniae serotype 6B from a patient with bacterial meningitis infection in Jakarta, Indonesia

The neurocritical care of tuberculous meningitis

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