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首页> 外文期刊>Infection >Tuberculous meningitis in adults: review of 61 cases.
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Tuberculous meningitis in adults: review of 61 cases.

机译：成人结核性脑膜炎61例复习。

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BACKGROUND: Tuberculosis is still a major cause of serious illness in developing countries. The objective of this study was to assess the clinical, laboratory, radiological and prognostic features of tuberculous meningitis (TBM) in immuncompetent adult patients. PATIENTS AND METHODS: Sixty-one patients with confirmed or presumed TBM seen over a 12-year period at the Neurology Department of Bakirkoy Research and Training Hospital for Psychiatric and Neurological Disease, Istanbul, Turkey, were analyzed retrospectively. Patients were grouped according to the severity of meningitis on admission (stages I, II and III). They were also divided into two groups according to the presence of paradoxical response (progressive increase of lymphocytes or increase of polymorphonuclear cells instead of lymphocytes) in CSF samples. A combination of five antituberculosis drugs was used in the 1st month of treatment. Patients received antituberculosis therapy for at least 12 months. The outcome of the patients was defined on the basis of the 12-month Barthel index (BI) score (BI < 12 poor; BI >/= 12 good). For statistical analysis death was included in the poor outcome group. RESULTS: Paradoxical response in CSF findings was seen in 20 patients. There was no statistically significant difference between the outcome of the patients with and without CSF paradoxical response; however, new tuberculomas developed more frequently in the first group (p < 0.05). The overall mortality was 27.8%. Stage of disease was found to be independently associated with the 12-month outcome (OR 7.2; 95% CI 1.7-30.3, p = 0.007). CONCLUSION: In developing countries such as Turkey, tuberculosis is still an important public health issue. Early suspicion and appropriate long-term antituberculosis therapy together with corticosteroids may reduce mortality and morbidity in TBM patients.
机译：背景：结核病仍然是发展中国家严重疾病的主要原因。这项研究的目的是评估具有免疫能力的成年患者的结核性脑膜炎（TBM）的临床，实验室，放射学和预后特征。病人和方法：回顾性分析了土耳其伊斯坦布尔巴基尔科伊精神病和神经病研究训练医院神经科的十二年内确诊或推测为TBM的61例患者。根据入院时脑膜炎的严重程度将患者分组（I，II和III期）。根据脑脊液样本中反常应答（淋巴细胞的逐渐增加或多形核细胞而不是淋巴细胞的增加）的存在，它们也分为两组。治疗的第一个月使用了五种抗结核药物的组合。患者接受抗结核治疗至少12个月。根据12个月的Barthel指数（BI）评分（BI <12差; BI> / = 12良好）定义患者的预后。为了进行统计分析，将死亡纳入不良结局组。结果：20例患者发现脑脊液发现存在反常反应。有和没有脑脊液悖论性反应的患者的预后之间没有统计学上的显着差异。但是，在第一组中，新发结核瘤的发生频率更高（p <0.05）。总死亡率为27.8％。发现疾病的阶段与12个月的结果独立相关（OR 7.2; 95％CI 1.7-30.3，p = 0.007）。结论：在土耳其等发展中国家，结核病仍然是重要的公共卫生问题。早期怀疑和适当的长期抗结核治疗以及皮质类固醇激素可降低TBM患者的死亡率和发病率。

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