Bacteriologically Confirmed Neuromeningeal Tuberculosis at the Hubert Koutoukou Maga National Hospital and University Center in Cotonou: About Two Cases Study and a Review of the Literature (original) (raw)
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Cerebro-Meningeal Tuberculosis in HIV-Negative Adults
Journal of Infectious Diseases and Epidemiology
Background: Tuberculosis remains a public health problem worldwide. Neurological localization is the most severe manifestation of extra-pulmonary tuberculosis characterized by a high mortality rate and a high rate of sequelae among survivors; its diagnosis is hampered by the absence of rapid and accurate tools, therefore it is often evoked and treated on presumption arguments. The aim of this study is to assess the epidemiological, clinical, diagnostic, treatment, and outcome features in patients with cerebro-meningeal tuberculosis in Setif-Algeria. Methods: We retrospectively studied the patient files followed for cerebro-meningeal tuberculosis at the infectious diseases department of the teaching hospital of Setif-Algeria from January 2005 to December 2016. Patients entered corresponded to the consensus cases definitions established in Cape Town-South Africa in 2010. Results: The included patients were 45 women and 26 men of nearly 41.7 years old (16-86). A history of tuberculosis had affected 6 patients and the disease was associated to extra-neurological tuberculosis in 37 patients. According to British Medical Research Council Staging of tuberculous meningitis, 23 were in stage I, 17 were in stage II, and 31 were in stage III. Neurological deficits are seen in 35 cases, they were numerous and various in some individuals. Cerebral imaging was pathological in 37 cases, multiple lesions were found: tuberculomas (21 cases), hydrocéphalus (10 cases), vascular lesions (7 cases), basal meningeal enhancement (21 cases)...etc. Magnetic resonance imaging was more contributive than cerebral tomodensitometry. 5 patients died and 13 had neurological sequelae with varying degree. The study showed that cerebral imaging was more pathologic in women (p = 0.01), and in people less than 65 years old (p = 0.04). The rate of death is more significant in elderly subjects (p = 0.001). Tuberculoma, hydrocephalus, and low cerebrospinal fluid glucose levels increase significantly when the diagnosis is delayed. Conclusion: Prompt diagnosis and early treatment are crucial to the successful management of tuberculous meningitis. Culture of Mycobacterium tuberculosis is too slow and insensitive to aid clinicians to make diagnosis. Therapeutic decision must be, to date, made on presumptive arguments and independently of the confirmation means.
Central Nervous System Tuberculosis- Case Report Case Report
Journal of Morphological Sciences
Mycobacterium tuberculosis is the leading cause of morbidity and mortality worldwide. Tuberculosis is the second most common cause of death due to an infectious agent worldwide after COVID-19 infection. Central nervous system tuberculosis, accounts for approximately 1% of all cases of tuberculosis, and the most common clinical presentation is tuberculous meningitis. Tuberculosis of the central nervous system is a devastating disease that, even under appropriate antituberculin therapy, leads to a high mortality rate. In this paper, we present a case report of a patient in whom the disease begins slowly, progressively, and chronically, with the initial clinical manifestation of dementia syndrome. Usually, tuberculous meningitis presents with a subacute progressive febrile illness. In 2 to 3 weeks defines meningitis phase with headache, meningismus, vomiting, mild confusion. Rare is the atypical presentation of CNS TB, as in our case. During the hospitalization, brain magnetic resonance was performed with suspicious findings for neuro infection. Due to the suspected finding of magnetic resonance imaging, a lumbar puncture was performed and the cerebrospinal fluid was sent for analysis for specific causes, including Mycobacterium tuberculosis. Correct diagnosis and therapy in these patients are a challenge for neurologists.
Introduction: Tuberculosis (TB) is highly prevalent in Bangladesh. The affection of the central nervous system(CNS) is one of the most dangerous manifestations of extrapulmonary tuberculosis. This may take the form of either tubercular meningitis (TBM), tuberculoma, or spinal arachnoiditis. CNS tuberculosis (CNS-TB) carries high morbidity and mortality among all forms of TB. The diagnosis is difficult and often delayed due to the varied and non-specific presentation. Aside from clinical indicators, cerebrospinal fluid (CSF) diagnostic indicators include mononuclear pleocytosis, low sugar levels, and high protein concentrations. It is possible to confirm Mycobacterium tuberculosis in CSF using staining, culture methods, and molecular analysis, but it is difficult. Advanced radiological imaging techniques can often be very helpful in making presumptive diagnoses, but they do not always yield confirm diagnoses. Aim: In our case series, we aimed to highlight the spectrum of presentation...
AIDS research and treatment, 2011
We conducted a retrospective review of confirmed HIV-TB coinfected patients previously enrolled as part of the SAPiT study in Durban, South Africa. Patients with suspected meningitis were included in this case series. From 642 individuals, 14 episodes of meningitis in 10 patients were identified. For 8 patients, this episode of meningitis was the AIDS defining illness, with cryptococcus (9/14 episodes) and tuberculosis (3/14 episodes) as the commonest aetiological agents. The combination of headache and neck stiffness (78.6%) was the most frequent clinical presentation. Relapsing cryptococcal meningitis occurred in 3/7 patients. Mortality was 70% (7/10), with 4 deaths directly due to meningitis. In an HIV TB endemic region we identified cryptococcus followed by tuberculosis as the leading causes of meningitis. We highlight the occurrence of tuberculous meningitis in patients already receiving antituberculous therapy. The development of meningitis heralded poor outcomes, high mortali...
Case Reports in Clinical Medicine
Background: Among patients treated for tuberculosis, 2% to 5% have a Central Nervous System (CNS) lesion, and its frequency rises to 10% in HIV-infected patients. Neuro-meningeal tuberculosis (NMT) is responsible for death and severe permanent neurological damage. This poor prognosis requires early diagnosis and rapid initiation of specific treatment. Unfortunately, the great clinical polymorphism and the lack of specificity of radiological and biological signs are frequently responsible for a delay in diagnosis and management. Senegal is one of the African countries where tuberculosis has remained a concern until now. And there are no studies carried out on this subject. Objective: The objective of this study was to describe the profile and outcome of Neuro-meningeal tuberculosis (NMT) cases diagnosed at the infectious diseases department (SMIT) of Fann University Hospital in Dakar, (referral service for management of tuberculosis). Methods: We carried out a retrospective, descriptive and analytical study, reviewing medical records of adults diagnosed with NMT at the SMIT of Fann Hospital from January 2015 to December 2020. Results: We collected 55 cases of NMT. The median age was 38 years [range 16-77 years]. The sex ratio (M/F) was 3.23. HIV patients represented 41.82% of cases. A history of tuberculosis was found in 25.5% of cases. The delay in consultation was greater than one month in 60% of patients. Headaches were the most constant reason for consultation (94.55%).
Clinical profile of Central Nervous System Tuberculosis in Kanniya kumari medical college
Background: Tuberculosis of the central nervous system is an important cause of morbidity and mortality. Once a disease mainly of childhood, it is now seen at any age and is equally frequent in adults. They may present as Meningitis, Tuberculoma, Potts Paraplegia, Intraspinal Granuloma or Arachnoiditis. This study was conducted to analyse various clinical presentations of CNS tuberculosis and their sequelae. Methods :An observational study was conducted in 30 patients admitted in Kanniyakumari Government Medical College from Jan 2016 to December 2016 with CNS manifestations of Tuberculosis. Computed tomography(CT), electroencephalography (EEG) and clinical findings were taken. Results: In the present study, the most common CNS presentation was Tuberculous Meningitis followed by Tuberculoma. Common age group being between 15-19 yrs. Aseptic meningitis had a good prognosis compared to Obstructive Hydrocephalus which had a bad prognosis. In this series, complete recovery was 66.6%, mortality was 13.4% and Sequelae in 20%.Conclusion: CNS tuberculosis is being reported more often nowadays due to its awareness and improved diagnostic modalities. Resistance to drugs has added a new challenge. Morbidity and mortality can be reduced by a great extent with early recognition and timely treatment
Case Report on Tuberculosis Meningitis-A Nurses Perspective
Journal of Pharmaceutical Research International
Mycobacterium tuberculosis is the bacteria that cause tuberculosis. If the infection is not treated immediately the bacterium passes via the circulatory system and spread other organs and tissues. Pathogen will travel to the meninges and causes inflammation of membranes called as tubercular meningitis. Here, the authors report a case of tuberculous meningitis a 42- years-old male patient with the chief complaints of low grade fever with chills since 1 month, headache in frontal region since 5-6 days, altered sensorium, breathing difficulty, reduced speech and left side weakness of the body since 1 day. After admitting in the ward all investigation done like MRI brain, ECG, lumbar puncture, blood tests etc. and he diagnosed as tuberculous meningitis. Patient admitted in AVBRH in ICU, investigations done, where patient was on NIV support, nasogastric tube, foleys catheter and it has been removed as patient was improving the condition and shifted in ward. Patient medical treatment in...
The Pattern Of Neurological Manifestations Of Tuberculosis Among Adult Sudanese Patients
Sudan Journal of Medical Sciences, 2008
Objective: To study the pattern of neurological manifestations of tuberculosis among adult Sudanese tuberculous patients seen at El-Shaab Teaching Hospital (Sudan). Methods: This study was performed on 179 Sudanese patients with tuberculosis admitted at El-Shaab Teaching Hospital during the period from May 2005 to January 2006. Demographic and clinical data were obtained. Investigations including CXR, sputum for acid alcohol fast bacilli [AAFB], Mantoux test, complete haemogram were done. Screening for HIV, NC Study, EMG, CT, MRI of the brain or spinal cord were performed when indicated. Results: Fifty seven out of 179 tuberculous patients had neurological complications. 22 presented with Pott's paraplegia, 18 with peripheral neuropathy, six had tubercloma, three with tuberculous meningitis, three had quadriplegia, two had hemiplegia, two had proximal myopathy and one had multiple cranial nerves palsies CONCULSION: The study revealed high incidence of Pott's paraplegia and peripheral neuropathy, this is most probably due to late presentation.