This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yaramis, A.
Right arrow Articles by Tas, M. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yaramis, A.
Right arrow Articles by Tas, M. A.
Related Collections
Right arrow Infectious Disease & Immunity

PEDIATRICS Vol. 102 No. 5 November 1998, p. e49

ELECTRONIC ARTICLE:
Central Nervous System Tuberculosis in Children: A Review of 214 Cases

Received Jun 24, 1996; accepted Jun 26, 1998.

Ahmet Yaramis*, Fuat Gurkan*, Murat ElevliDagger , Murat Söker*, Kenan Haspolat*, Gökhan Kirbas*, §, and M. Ali Tas*

From the * Division of Pediatric Diseases, Medical School, Dicle University, Diyarbakir, Turkey; Dagger  Division of Pediatric Diseases, Medical School, Kocaeli University, Kocaeli, Turkey; and § Department of Pulmonology, Medical Clinic, University of Freiburg, Freiburg, Germany.

Objective.  To study the clinical, laboratory, and treatment features observed in pediatric patients with tuberculous meningitis in Turkey.

Study Design.  Retrospective case review study.

Methods.  Review of medical records for demographic data, medical history, clinical manifestations, auxiliary test results, complications, and treatment of 214 children with central nervous system tuberculosis (TB) admitted to Dicle University's hospital between August 1988 and February 1996.

Results.  Of the 214 patients with tuberculous meningitis, 112 (52%) were male. The mean age at presentation was 4.1 years, with 165 patients (77%) younger than 5 years. Twenty-two patients (10%) were in the first stage of the disease, 120 (56%) in the second, and 72 (34%) in the third. Our epidemiologic data showed that 141 (66%) of the patients had a family history of TB, and 64 (30%) had a Mantoux skin test result of >10 mm of induration. Radiographic studies demonstrated abnormal chest findings in 187 patients (87%) (hilar adenopathy, 33%; infiltrates, 33%; miliary pattern, 20%; and pleural effusions, 1%, and 172 (80%) cases with hydrocephalus, 26% with parenchymal disease, 15% with basilar meningitis, and 2% with tuberculomas. Only 22 (13%) of 164 children had a positive acid-fast bacilli smear in cerebrospinal fluid, and Mycobacterium tuberculosis was isolated in 49 patients (30%). All the patients were treated with Isoniazid, rifampin, and streptomycin or pyrazinamide for 2 months, followed by 10 months of Isoniazid and rifampin alone. Also, all the patients received adjuvant treatment with steroids early in the course of treatment, and 140 of 172 cases with hydrocephalus had surgical intervention. The overall mortality rate was 23%.

Conclusion.  One or more of these findings: a family history of TB, positive tuberculin skin test results, abnormal cranial computed tomography, and/or cerebrospinal fluid analysis compatible with TBM were found in all but 3 children in our study. central nervous system, tuberculous meningitis, diagnosis, hydrocephalus, children. .