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- W2169076185 abstract "Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis (TB) and has very high morbidity and mortality. TBM is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Characteristic cerebrospinal fluid (CSF) findings of TBM include a lymphocytic-predominant pleiocytosis, elevated protein, and low glucose. CSF acid-fast smear and culture have relatively low sensitivity but yield is increased with multiple, large volume samples. Nucleic acid amplification of the CSF by PCR is highly specific but suboptimal sensitivity precludes ruling out TBM with a negative test. Treatment for TBM should be initiated as soon as clinical suspicion is supported by initial CSF studies. Empiric treatment should include at least four first-line drugs, preferably isoniazid, rifampin, pyrazinamide, and streptomycin or ethambutol; the role of fluoroquinolones remains to be determined. Adjunctive treatment with corticosteroids has been shown to improve mortality with TBM. In HIV-positive individuals with TBM, important treatment considerations include drug interactions, development of immune reconstitution inflammatory syndrome, unclear benefit of adjunctive corticosteroids, and higher rates of drug-resistant TB. Testing the efficacy of second-line and new anti-TB drugs in animal models of experimental TBM is needed to help determine the optimal regimen for drug-resistant TB." @default.
- W2169076185 created "2016-06-24" @default.
- W2169076185 creator A5044041242 @default.
- W2169076185 creator A5065910920 @default.
- W2169076185 date "2011-01-01" @default.
- W2169076185 modified "2023-10-12" @default.
- W2169076185 title "Tuberculous Meningitis: Diagnosis and Treatment Overview" @default.
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- W2169076185 doi "https://doi.org/10.1155/2011/798764" @default.
- W2169076185 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3335590" @default.
- W2169076185 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/22567269" @default.
- W2169076185 hasPublicationYear "2011" @default.
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