Adjuvant immunosuppression for paradoxical deterioration in tuberculous meningitis including one case responsive to cyclosporine. A tertiary referral hospital experience

We report a case series of TBM admissions to our institution including one case with paradoxical de terioration refractory to corticosteroids who responded to adjuvant cyclosporine.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Source Type: research

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Conclusions: CNS TB is treated by neurologists and physicians in India, as per their experience due to different recommendations in various guidelines. There is a tendency to decide when to stop treatment based on neuroimaging given the fear of poor outcomes associated with recurrence of the disease. The duration of treatment or choice of drugs at the start of treatment did not affect disability.
Source: Annals of Indian Academy of Neurology - Category: Neurology Authors: Source Type: research
Authors: Beaman MH Abstract Meningitis and encephalitis are medical emergencies. Patients need prompt evaluation and immediate empiric therapy to reduce the likelihood of fatal outcomes and chronic neurological sequelae. Conjugate bacterial vaccines have significantly reduced the incidence of bacterial meningitis, especially in children. As the results of changes in patterns of bacterial drug sensitivity, ceftriaxone is now part of the recommended empiric treatment for bacterial meningitis and should be administered as early as possible. Neuroimaging delays the treatment of meningitis and is not needed in most case...
Source: Medical Journal of Australia - Category: General Medicine Tags: Med J Aust Source Type: research
Authors: Meregildo Rodriguez ED Abstract Central nervous system (CNS) tuberculosis includes three clinical entities: tuberculous meningitis, intracranial tuberculoma, and spinal tuberculous arachnoiditis. All three categories are encountered frequently in regions of the world where the incidence of TB is high. Meningeal tuberculosis is a medical emergency: it is the most severe, lethal and disabling form of tuberculosis. Early diagnosis and treatment can be lifesaving. Even, in developed countries the diagnosis of tuberculous meningitis is difficult, frequently delayed or missed, and is often not microbiologically ...
Source: Infezioni in Medicina - Category: Infectious Diseases Tags: Infez Med Source Type: research
Authors: Franco-Herrera D, González-Ocampo D, Restrepo-Montoya V, Gómez-Guevara JE, Alvear-Villacorte N, Rodríguez-Morales AJ Abstract Central nervous system (CNS) tuberculosis includes three clinical entities: tuberculous meningitis, intracranial tuberculoma, and spinal tuberculous arachnoiditis. All three categories are encountered frequently in regions of the world where the incidence of TB is high. Meningeal tuberculosis is a medical emergency: it is the most severe, lethal and disabling form of tuberculosis. Early diagnosis and treatment can be lifesaving. Even, in developed countries the ...
Source: Infezioni in Medicina - Category: Infectious Diseases Tags: Infez Med Source Type: research
Tuberculous meningitis is the commonest and the most severe form of central nervous system tuberculosis associated with a high rate of morbidity and mortality. Early treatment with anti-tuberculosis therapy along with adjunctive corticosteroids can reduce the rates of death and disability due to tuberculous meningitis; however, almost half of patients with tuberculous meningitis still die or are left with severe disabilities.1
Source: Journal of Infection - Category: Infectious Diseases Authors: Source Type: research
We describe a case of an Italian child. Diagnoses: we diagnosed early a Tuberculous meningitis complicated by the occurrence of hydrocephalus, stroke, and paradoxical reaction with brain pseudo-abscesses. Interventions: The child started readily a specific therapy associated with steroids and thalidomide was introduced few month later. Outcomes: the patient had a favorable outcome without neurologic sequelae. Lessons: Despite the prompt specific anti-tubercular and adjuvant corticosteroid therapies, only the addition of thalidomide to the treatment allow to a favorable clinical outcome.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 008 Peer Reviewer Dr McBride ID physician, Wisconsin TB affects 1/3rd of the population and one patient dies every 20 seconds from TB. Without treatment 50% of pulmonary TB patients will be dead in 5 years. In low to middle income countries both TB and HIV can be ubiquitous, poor compliance can lead to drug resistance and malnourished infants are highly susceptible. TB can be very complex and this post will hopefully give you the backbone t...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine Genexpert meningitis TB TB meningitis Tuberculosis Source Type: blogs
AbstractTo present an unrecognized vascular complication of bacillus Calmette-Gu érin (BCG) therapy administered for superficial bladder carcinoma. We also review the potential mimickers for primary angiitis of the central nervous system (PACNS) as well as complications of intravesical BCG therapy. An 89-year-old Caucasian man with a history of relapsing high-grade bladder carc inoma treated with intravesical BCG presented with recurring episodes of right upper limb paresthesia with clumsiness and dysarthria. Magnetic resonance imaging of the head revealed multiple predominantly left-sided frontotemporal micronodula...
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research
AbstractPurpose of ReviewTuberculous meningitis is the most devastating manifestation of infection withMycobacterium tuberculosis and represents a medical emergency. Approximately one half of tuberculous meningitis patients die or suffer severe neurologic disability. The goal of this review will be to review the pathogenic, clinical, and radiologic features of tuberculous meningitis and to highlight recent advancements in translational and clinical science.Recent FindingsPharmacologic therapy includes combination anti-tuberculosis drug regimens and adjunctive corticosteroids. It is becoming clear that a successful treatmen...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Conditions:   Tuberculosis;   Tuberculous Meningitis;   Drug-Induced Liver Injury Interventions:   Drug: Dexamethasone;   Other: Placebo Sponsors:   Oxford University Clinical Research Unit, Vietnam;   Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam;   Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam Not yet recruiting - verified April 2017
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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