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Boletín Médico del Hospital Infantil de México

2006, Number 5

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Bol Med Hosp Infant Mex 2006; 63 (5)

Infection by mycobacterias of the central nervous system.

Morales-Aguirre JJ

Language: Spanish
References: 160
Page: 332-350
PDF size: 122.01 Kb.


ABSTRACT

Tuberculous meningitis is the most severe infection caused by Mycobacterium tuberculosis, it represents about 5-15% of extrapulmonary tuberculosis. The clinical manifestations are divided in 3 stages, being the major signs fever, vomiting, apathy, anorexia, irritability, upper respiratory infections, headache, abdominal pain, seizures, constipation, lethargy, neck pain and rigidity, cough, weight loss, hydrocephalus. Diagnosis is often difficult, because chest x rays, PPD and mycobacterial cultures are usually negative; due to the low mycobacterial count in cerebral spinal fluid (CSF). The recommended treatment include 2 months with isoniazid, rifampin, streptomycin and pyrazinamide, followed by isoniazid and rifampin for 7-10 months, in addition to corticosteroids. Sequelae are more common in advanced stages of disease. Before this treatment was introduced, patients died in a period of 3-4 weeks. If the treatment is administered in the first stages of the disease, life spectancy is practically 100%; however neurological sequelae are not uncommon.


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