Clinical and diagnostic features of central nervous system tuberculosis in Indian children - a descriptive study.

IF 3.8 Q2 INFECTIOUS DISEASES

Therapeutic Advances in Infectious Disease Pub Date : 2024-09-12 eCollection Date: 2024-01-01 DOI:10.1177/20499361241274251

Bella Devaleenal Daniel, Elilarasi Selladurai, Sarath Balaji, Arunagirinathan Venkatesan, Mythily Venkatesan, Prathiksha Giridharan, Sivakumar Shanmugam, Saravanan Natrajan, Ramesh Karunaianantham, Devika Kandasamy, Rajakumar Subramani, Kannan Muthuramalingam, Snegha K Pramila, Syed Hissar, Kelly E Dooley, Kiran T Thakur

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引用次数: 0

Abstract

Background: Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features.

Objective: To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma).

Design: Retrospective descriptive study.

Methods: Children less than 12 years presenting with neurological signs and symptoms were assessed for a therapeutic TBM trial eligibility. The results of their clinical, laboratory, neuroimaging, cerebrospinal fluid evaluations were analysed for TBM diagnosis.

Results: Of 600 children evaluated, 61(10%) had CNS tuberculosis; TBM 47, tuberculoma 14. 20(33%) had definite TBM. Mean age of children with TBM was 5 ± 3.4 years. Of 47, 13(28%), 21(45%) and 13(28%) had grade I, II, and III disease respectively. Abnormalities suggestive of TBM in MRI and computed tomography brain were observed in 76% (26/34) and 77% (24/31) respectively. Abnormal cerebrospinal fluid white blood cell count, protein and glucose were observed in 56% (24/43), 49% (22/45), 47% (21/45) respectively. Among 41 patients with TBM followed up until discharge, five died.

Conclusion: Younger children with TBM have severe forms. Confirmatory results may not be available in all. A holistic approach to care including addressing complications of hydrocephalus and strokes is needed.

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印度儿童中枢神经系统结核病的临床和诊断特征--一项描述性研究。

背景：结核性脑膜炎（TBM）患儿往往具有不典型的临床特征，因此给诊断带来了困难：描述确诊为中枢神经系统（CNS）结核（TBM 和结核瘤）患儿的基线特征：设计：回顾性描述性研究：对出现神经系统症状和体征的 12 岁以下儿童进行 TBM 治疗试验资格评估。对他们的临床、实验室、神经影像学和脑脊液评估结果进行分析，以确诊 TBM：在接受评估的 600 名儿童中，61 人（10%）患有中枢神经系统结核；47 人患有 TBM，14 人患有结核瘤。患 TBM 儿童的平均年龄为 5 ± 3.4 岁。47名患儿中，分别有13名（28%）、21名（45%）和13名（28%）患有I级、II级和III级疾病。76%（26/34）和77%（24/31）的患者在核磁共振成像和计算机断层扫描中发现异常，提示脑肿瘤。脑脊液白细胞计数、蛋白质和葡萄糖异常的比例分别为 56%（24/43）、49%（22/45）和 47%（21/45）。在 41 名 TBM 患者中，有 5 人在出院前死亡：结论：年龄较小的 TBM 患儿病情较重。结论：TBM 患儿年龄较小，病情较重，并非所有患者都能获得确诊结果。需要采取整体护理方法，包括处理脑积水和中风并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Infectious Disease INFECTIOUS DISEASES-

CiteScore

5.30

自引率

8.80%

发文量

审稿时长

9 weeks