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
{"title":"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。","authors":"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","doi":"10.1177/20499361241274251","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features.</p><p><strong>Objective: </strong>To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma).</p><p><strong>Design: </strong>Retrospective descriptive study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"11 ","pages":"20499361241274251"},"PeriodicalIF":3.8000,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406600/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical and diagnostic features of central nervous system tuberculosis in Indian children - a descriptive study.\",\"authors\":\"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\",\"doi\":\"10.1177/20499361241274251\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features.</p><p><strong>Objective: </strong>To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma).</p><p><strong>Design: </strong>Retrospective descriptive study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":46154,\"journal\":{\"name\":\"Therapeutic Advances in Infectious Disease\",\"volume\":\"11 \",\"pages\":\"20499361241274251\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2024-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406600/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Infectious Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20499361241274251\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Infectious Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20499361241274251","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Clinical and diagnostic features of central nervous system tuberculosis in Indian children - a descriptive study.
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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