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Órgano Oficial de la Asociación Mexicana de Infectología Pediátrica y la SLIPE.

2007, Number 81

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Rev Enfer Infec Pediatr 2007; 20.21 (81)

Tuberculous meningitis in the Hospital Infantil de Mexico: analysis of clinical features in 47 cases

Coria LJJ, Lozano VFM, Juárez EM, Rosales URE

Language: Spanish
References: 28
Page: 18-25
PDF size: 462.80 Kb.


ABSTRACT

Introduction: the tuberculous meningitis continues being one of the infections more severe than attempt against the life of the pediatric patient, with important neurological sequels and a great morbidity and mortality Objective: describe and know the clinical characteristics and evolution of tuberculous meningitis in a group from our hospital center. Material and methods: a retrospective revision of the clinical files of 47 children with tuberculous meningitis, which were studied at the Hospital Infantil de Mexico of january 1, 1991 to december 31, 2000. The following variables were analyzed: age, sex, clinical stage of presentation, signs and symptoms associated, radiological pattern, computerized tomography findings, methods of diagnosis and mortality. Results: overall, tuberculous meningitis cases were classified (according to the British Research Council) as grade II. Fever and neurological manifestations were observed in all the stages. The PCR (Reaction of Polymerase in Chain) in cerebrospinal fluid (CSF) was positive in 10%, and the Cranial Computed Tomography (TAC) showed basal arachnoiditis and hydrocephalus. Four patients died. Conclusions: the febrile processes with unspecific neurological signs must alert the doctor in the search of data epidemiologists, application of a directed clinical history, and accomplishment of specific diagnostic tests to evaluate a picture of tuberculous meningitis.


REFERENCES

  1. Jacobs RF, Strake JR. Tuberculosis in Children. Med Clin North Am 1993,77:1335-1351.

  2. Waagner DC. The Clinical presentation of Tuberculosis Disease in Children. Pediatric Ann. 1993; 10: 622.

  3. Idriss SH, Anwar AS, KronfolNM. Tuberculosis Meningits in Childhood. Am J Dis Child.1976;130:364-67.

  4. Waecker NJ, Connor JD. Central nervous system tuberculosis in children: a review of 30 cases. Pediatr Infect Dis J. 1990;9:539-43.

  5. Gutiérrez RM, Solís Ma-IM, Moran FL. Meningitis tuberculosa. En: Gómez DB, Coria JJL (eds). Infectología Práctica en el Paciente Pediátrico. 1ª ed. Corinter. México.2003:109-116.

  6. CDC. Screening for tuberculosis and tuberculosis infection in high risk populations and the use of preventive therapy for tuberculosis infection in the United States. MMWR.1995;44(RR-11):19-34.

  7. Stamos JK, Rowley AH. Pediatric Tuberculosis: An Update. Curr Prob Pediatrics. 1995;25:131-6.

  8. Lincoln EM, Sordillo SVR, Davies PA. Tuberculous meningitis in children. J Pediatr.1960;57:807-23.

  9. Paláu J-MC. Neuroinfección. En: Álvarez EP, Paláu J-MC (eds). Infecciones en Pediatra, Prevención, diagnóstico y tratamiento. 2ª ed. McGraw-Hill. Santafé de Bogotá. 1997:Cap.29:323.

  10. Conelly KS. Tuberculous in children. Curr Pediatr.2001;31:1-34.

  11. Hernández PM, Arredondo JL, González SN. Meningitis Tuberculosa en Niño. Acta Pediátrica de México. 1982;13:165-171.

  12. Curless ERFG, Mitchell CD. Central Nervous System Tuberculosis In Children Pediatric Neurol. 1991;17:270-274.

  13. Leonard JM, Des Prez RM. Tuberculous meningitis. Infect Dis Clin North Am 1990;4:769-787.

  14. American Academy of Pediatric. Report of the Committee on Infectous Diseases. Red Book. 25th edition. 2000:Pág. 607.

  15. Farinha NJ. Razali KA. Holzel H. Morgan G. Novelli VM. Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3 JH, U.K: Tuberculosis of the central nervous system in children: a 20-year survey. Journal of Infection. 2000;41:61-8.

  16. Paganini H, Gonzalez F, Santander C, Casimir L. Tuberculosis meningitis in children: Clinical feautures and outcome in 40 cases. Scandinavian Journal of Infectous Disease. 2000;32:45-54.

  17. Karam JB, Sosa R, Naime JEL, Posada EEM. Meningitis tuberculosa: Análisis de diez años en el Hospital Infantil de México “Dr Federico Gómez”. Sal Pub Méx. 1991;33:70-6.

  18. Delgado MM, Chávez LGM, Olvera JER, López JL, Carrera EG, Manríquez JJO. Algunos datos de la neurotuberculosis obtenidos en la revisión de 13,698 autopsias. Patología.1992:30:139-43.

  19. Mac Gregor RR. Tuberculosis: from history to current management. Semin Roent 1993;12:101-108.

  20. Lehler H. The angiographic triad of tuberculous meningitis. Radiology. 1966;87:829-35.

  21. Datsur DK, Lalitha VS, Prabhakar V. Pathological analysis of inracranial space-occupyng lesions in 1,000 cases including children: I. Age, sex, and pattern; and the tuberculomas. J Neurol Sci.1968;6:575-92.

  22. Alsoub H. Hamad medical Corporation, Doha-Qatar. Tuberculous Meningitis: a clinical and laboratory study of 20 patients in Qatar. International Journal of Clical Practice. 1998;52:300-4.

  23. Parrilla JS, Sánchez Fernández N, Cintado Bueno C. Sección de infectología pediátrica. Hospital Infantil universitario Virgen del Roció, Sevilla. Meningitis Tuberculosa. Una enfermedad en regresión en nuestro medio?. Anal Espa Pediatr. 2000;52232-7.

  24. Leung AN.Muller NL. et. al. Primary Tuberculosis in Childhood: Radiographic Manifestations. Radiology. 1992 ;182:87-91.

  25. Morkowitz RI, Kramer SS. Pulmonary Tuberculosis in Children. Seminars in Roentgenology. 1993;12:158-72.

  26. Lamont AC, Cremin BJ, Pelteret RM. Radiological patterns of pulmonary tuberculosis in the paediatric age group. Pediatric Radiol. 1896; 16: 2-7

  27. Ozates M. Kemaloglu S. Gurkan F. Ozkan U. CT of the brain in tuberculous meningitis. A review of 289 patients. Acta Radiológica. 2000;41:13-7.

  28. Tartaglione T. Di Lella GM. Cerease A. Leone A. Moschi. Diagnostic imaging of neurotuberculosis (Review) Rays.1998;23:164-80.




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