Abstract
Background and aims: Tuberculous meningitis (TBM) accounts for 0.7% of all cases of tuberculosis (TB). The incidence is related to the prevalence of TB in the community. In Portugal BCG vaccine is routinely administered and has been proven to reduce the incidence of severe disseminated disease in children.
Methods: Retrospective study, between January 2000 and December 2010, of children with TBM. Diagnosis confirmed by culture and/or polymerase chain reaction of the CSF or cerebral tissue.
Results: 5 patients, mean 4.2 years old (9 months-10 years); one of african origin. All children were immunized against Mycobacterium tuberculosis. Fever was the first clinical manifestation in four children, accompanied by vomiting (5), malaise (3), lethargy (5), headache (2), cough (2), with more than two weeks in duration in three. One had concomitant miliary disease. Tuberculin skin test was positive only in one and all had contact with patients with TB. There was one multidrug-resistant TBM. First line agents were replaced in two patients because of oral intolerance and antimicrobial resistance. 4/5 required intensive care. Complications occurred in all cases: seizures (3), coma (3), cranial nerve paralysis (2), cerebral stroke (1), motor disabilities (3), hydrocephalus (5) and venous thrombosis (1). One child died, whose diagnosis was made postmortem.
Conclusion: TB remains among the great public health challenges. It should be considered when diagnosing children with nonpecific/subacute symptoms of neurologic infection, even in absence of respiratory symptoms or an epidemiologic context. Death may occur as a result of missed diagnosis and delayed treatment.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cabral, M., Varandas, L., Gouveia, C. et al. 885 Tuberculous Meningitis: A Rare and Severe Form of An Emerging Disease?. Pediatr Res 68 (Suppl 1), 444 (2010). https://doi.org/10.1203/00006450-201011001-00885
Issue Date:
DOI: https://doi.org/10.1203/00006450-201011001-00885