Challenges in conducting trials for pediatric tuberculous meningitis: lessons from the field

Source: International Journal of Tuberculosis and Lung Disease - Category: Respiratory Medicine Authors: Tags: ORIGINAL ARTICLES Source Type: research

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Tuberculous meningitis is the most devastating presentation of disease with Mycobacterium tuberculosis. We sought to evaluate treatment outcomes for adult patients with this disease.
Source: BMC Pulmonary Medicine - Category: Respiratory Medicine Authors: Tags: Research article Source Type: research
ConclusionsAlthough various cases of active pulmonary, renal and abdominal tuberculosis have been documented in association with NMOsd, no mechanism of association has been discovered; interestingly, the seropositive for NMOsd is variable. We theorized that a genetic background in our population might be associated with this uncommon phenotype. If this phenomenon corresponds to an immune dysfunction caused directly by the bacillus, direct tuberculosis infection or a cross ‐reaction is to be determined.
Source: Clinical and Experimental Neuroimmunology - Category: Neurology Authors: Tags: Case Report Source Type: research
Condition:   Tuberculous Meningitis Interventions:   Drug: Aspirin;   Drug: Placebo of aspirin;   Drug: WHO TBM treatment;   Drug: Intensified TBM treatment Sponsors:   French National Institute for Health and Medical Research-French National Agency for Research on AIDS and Viral Hepatitis (Inserm-ANRS);   European Union;   European and Developing Countries Clinical Trials Partnership (EDCTP) Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Opportunistic infections are those that are either more frequent or more severe as a result of the patient’s immunosuppressed condition. Opportunistic infections are, of course, the distinguishing feature of HIV infection, and they can be the cause of serious morbidity and even mortality. Some opportunistic infections can be prevented by vaccination, for example, pneumococcal infection, meningococcal infection, influenza, hepatitis A and B, and varicella. Other major opportunistic infections require prophylactic antibiotics or antiviral medications. In obstetric patients, pneumocystis infections and toxoplasmosis are...
Source: Clinical Obstetrics and Gynecology - Category: OBGYN Tags: New Antibiotics and Antibiotic Prophylaxis in Obstetrics Source Type: research
Purpose of review Describe the range of infectious causes of ocular motor neuropathies, from common presentations to unusual manifestations of diseases less frequently seen in the developed world. Provide information on recent developments in diagnostic testing for pathogens that may cause ocular motor neuropathies. Recent findings Antigen detection in serum or CSF has improved the diagnosis of cryptococcal disease. Cartridge PCR testing for tuberculosis has increased diagnostic accuracy, though tuberculous meningitis remains difficult to diagnose. Rapid, multiplex PCR and unbiased sequencing allow for diagnosis of a ...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research
In this study, we report a new method for detecting cell-free Mycobacterium tuberculosis DNA (cf-TB) in CSF and evaluate its clinical value for TBM diagnosis. METHODS: Of 68 patients prospectively recruited, 46 were diagnosed as having TBM and 22 as non-TBM. We compared the cf-TB method with CSF smear microscopy, mycobacterial culture, and the Xpert MTB/RIF assay (Xpert) using the consensus case definition for TBM proposed in 2009 as a reference standard. RESULTS: The sensitivity of the cf-TB test was 56.5% (26/46) in patients with TBM, and it was significantly higher than other methods: microscopy (2.2%, 1/46; P
Source: American Journal of Clinical Pathology - Category: Pathology Authors: Tags: Am J Clin Pathol Source Type: research
Muscular hypotonia is considered as one of the rarest forms of initial onset signs of TBM, in addition to aphasia and hyponatremia, the awareness of those rare onset signs, a well ‐conducted diagnostic approach and early treatment can improve the outcome. AbstractMuscular hypotonia is considered as one of the rarest forms of initial onset signs of TBM, in addition to aphasia and hyponatremia, the awareness of those rare onset signs, a well ‐conducted diagnostic approach and early treatment can improve the outcome.
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
Semin Neurol 2019; 39: 482-494 DOI: 10.1055/s-0039-1687915Central nervous system (CNS) infections are a frequently underappreciated potential etiology of cerebrovascular disease. Highlighted in this review are a selection of infectious agents that lead to cerebrovascular complications through various mechanisms including multifocal vasculopathy, focal infiltrative vasculitis and vasospasm, and direct vessel wall invasion and thrombus formation. Diagnosis of stroke due to underlying CNS infection requires a high index of clinical suspicion and careful consideration of neuroimaging, serum, and cerebrospinal fluid studies in ...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
We describe demographic, socioeconomic and clinical characteristics of patients randomized to the same-day initiation arm for both studies. RESULTS AND DISCUSSION: A total of 240 and 296 participants were enrolled in Kenya and South Africa. The majority were female (59% and 64% respectively), with a median age of 35 years. In both countries, most subjects were newly diagnosed with HIV on the day of enrolment (62%, 55%), believed they already had adequate knowledge to begin ART (78%, 68%), and preferred to start ART immediately (same-day) (98% in both countries). About 40% of all patients had at least one symptom r...
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
CONCLUSIONS: Diagnosis of EPTB and PTB at ART programmes in LMIC was mainly based on clinical criteria. Greater availability and usage of TB diagnostic tests would improve the diagnosis and clinical outcomes of both EPTB and PTB. PMID: 31507083 [PubMed - in process]
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
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