Clinical and diagnostic characteristics of meningeal tuberculosis in adults, Bogota (Colombia)
PDF (Español)
HTML (Español)

Keywords

Clinical presentation
diagnostic tests
meningeal tuberculosis (MeSH)

Abstract

Introduction: Infection with Mycobacterium Tuberculosis is a worldwide disease whose main clinical manifestation is pulmonary, meningeal tuberculosis is the second most common extra-pulmonary presentation after pleural represents a high morbidity and mortality, early diagnosis and treatment reduces these outcomes.

Objective: The aim of the study was to establish the clinical characteristics of patients with meningeal tuberculosis in our institutions and evaluation of the results obtained with the diagnostic methods available.

Materials and methods:A descriptive cross-sectional study was conducted by reviewing the medical records of patients with meningeal tuberculosis; in the period between 2003-2012, two institutions third and fourth level of care in Bogotá.

Results: 36 patients with meningeal tuberculosis, with a mean age of 52.4 years, 63.8% male, 16.6% coinfection with human immunodeficiency virus were evaluated. The subacute and chronic clinical presentation was 49.9%, 86.1% had headache, other symptoms were fever, neck rigidity, among others. In cerebrospinal fluid protein levels were 100%, 88.8% hypoglycorrhachia. 71.8% in microbiological studies were positive adenosine deaminase, 30.4% positive chain reaction polymerase and 41.1% positive culture. Hyponatremia was 36.1%. In neuroimaging, 18.7% and 17.6% had hydrocephalus Pachymeningitis.

Conclusion: The meningeal tuberculosis today represents a diagnostic challenge because there is no method available with the ideal characteristics of a diagnostic test, having considered the clinical manifestations of subacute or chronic meningitis and cerebrospinal fluid findings in primary for diagnosis and initiation early treatment.

https://doi.org/10.22379/2422402222

PDF (Español)
HTML (Español)

References

GIRGIS NI, SULTAN Y, FARID Z, MANSOUR MM, ERIAN MW, HANNA LS, ET AL. Tuberculosis meningitis, Abbassia Fever Hospital-Naval Medical Research Unit No. 3-Cairo, Egypt, from 1976 to 1996. Am J Trop Med Hyg. 1998 Jan;58(1):28-34.

PARIJA S, GIREESH A. Early diagnosis of tuberculous meningitis: A comparison of nested polymerase chain reaction and BacT/ALERT. Indian J Pathol Microbiol. 2011;54(2):421.

ORGANIZACIÓN MUNDIAL DE LA SALUD. Global tuberculosis report 2012. Geneva: World Health Organization; 2012.

GARG RK. Tuberculous meningitis. Acta Neurol Scand. 2010 Aug;122(2):75-90.

ENBERG GM, QUEZADA MD, DE TORO VC, FUENZALIDA LL. Tuberculous meningitis in adults: review of 53 cases. Rev Chil Infectol Órgano Of Soc Chil Infectol. 2006 Jun;23(2):134-9.

ROCA B, TORNADOR N, TORNADOR E. Presentation and outcome of tuberculous meningitis in adults in the province of Castellon, Spain: a retrospective study. Epidemiol Infect. 2008 Nov;136(11):1455-62.

QUAN C, LU C-Z, QIAO J, XIAO B-G, LI X. Comparative evaluation of early diagnosis of tuberculous meningitis by different assays. J Clin Microbiol. 2006 Sep;44(9):3160-6.

CHRISTENSEN A-SH, ANDERSEN ÅB, THOMSEN VØ, ANDERSEN PH, JOHANSEN IS. Tuberculous meningitis in Denmark: a review of 50 cases. BMC Infect Dis. 2011;11(1):47.

PRASAD K, VOLMINK J, MENON G. Steroids for treating tuberculous meningitis. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2000 [citado en 2015 Mar 7]. Recuperado de http://doi.wiley.com/10.1002/14651858.CD002244.

MARAIS S, THWAITES G, SCHOEMAN JF, TÖRÖK ME, MISRA UK, PRASAD K, ET AL. Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis. 2010 Nov;10(11):803-12.

THWAITES GE. The Diagnosis and Management of Tuberculous Meningitis. Pract Neurol. 2002 Oct;2(5):250-61.

THWAITES G, FISHER M, HEMINGWAY C, SCOTT G, SOLOMON T, INNES J. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect. 2009 Sep;59(3):167-87.

JUAN RS, SÁNCHEZ-SUÁREZ C, REBOLLO MJ, FOLGUEIRA D, PALENQUE E, ORTUÑO B, ET AL. Interferon gamma quantification in cerebrospinal fluid compared with PCR for the diagnosis of tuberculous meningitis. J Neurol. 2006 Oct;253(10):1323-30.

TUON FF, HIGASHINO HR, LOPES MIBF, LITVOC MN, ATOMIYA AN, ANTONANGELO L, ET AL. Adenosine deaminase and tuberculous meningitis-a systematic review with meta-analysis. Scand J Infect Dis. 2010 Mar;42(3):198-207.

THWAITES GE, NGUYEN DB, NGUYEN HD, HOANG TQ, DO TTO, NGUYEN TCT, ET AL. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004 Oct 21;351(17):1741-51.

GUPTA BK, BHARAT A, DEBAPRIYA B, BARUAH H. Adenosine Deaminase Levels in CSF of Tuberculous Meningitis Patients. J Clin Med Res. 2010 Oct 11;2(5):220-4.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Downloads

Download data is not yet available.