Cases reported "Tuberculosis, Meningeal"

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1/10. Tuberculous meningoencephalitis in hiv-seronegative patients: variety of clinical presentation and impact on diagnostics and treatment.

    Tuberculous meningoencephalitis (TBM), an infrequent disease in Western European countries, shows a wide heterogeneity of clinical symptoms. MATERIAL AND methods: We present 4 patients (age range 42-72 years) with the definite diagnosis of isolated TBM. All patients were hiv-seronegative, only 1 patient was known to be immunoincompetent on admission due to acute myelocytic leukemia; other reasons for immune suppression were detected in 2 other patients (leukemia and idiopathic CD4 T-lymphocytopenia, respectively). RESULTS: The diagnosis of TBM was confirmed in 3 cases by culture from CSF, in 1 case mycobacterium tuberculosis was proven only in tracheal aspirate. In 1 patient M. bovis was found, which is an extremely rare cause of TBM in germany. We report the contributions of different diagnostic tools (CSF analysis, neuroimaging) in reaching the presumptive diagnosis and in monitoring the further course. All patients developed neurological complications despite prompt tuberculostatic treatment. Three of the patients presented a chronic severe loss of consciousness of unclear origin. CONCLUSION: The possible causative relationships of these complications and their impact on the prognosis are discussed.
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ranking = 1
keywords = bovis
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2/10. Molecular and histopathologic evidence for systemic infection by mycobacterium bovis in a patient with tuberculous enteritis, peritonitis, and meningitis: a case report.

    mycobacterium bovis infection has been reported in several patients with AIDS in other countries. The prevalence of tuberculosis in taiwan is higher than the world health organization standard. However, reports of M. bovis infection are rare. A 47-year-old male had the habit of drinking uncooked fresh deer's blood and unpasteurized deer's milk. He suffered from acute abdominal pain and underwent emergency laparotomy. pathology demonstrated tuberculosis enteritis with colon perforation. The molecular diagnosis by nested polymerase chain reaction assay and single-strand conformation polymorphism assay showed M. bovis infection in the small intestine, mesenteric lymph nodes, and cerebrospinal fluid (CSF). Our results suggest that the most likely portal of entry of M. bovis is the gastrointestinal rather than the respiratory tract. Ingested M. bovis from unpasteurized deer's milk probably entered the mucosal macrophages of the intestine and then the draining mesenteric lymph nodes. As immunity declined, bacilli from the mesenteric lymph nodes disseminated to other organs and into the CSF.
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ranking = 9
keywords = bovis
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3/10. Complex clonal features in an mycobacterium tuberculosis infection in a two-year-old child.

    The focus of this report is to describe the highly complex clonal features of the mycobacterium tuberculosis (MTB) isolates cultured from a 2-year-old child with no risk factors for tuberculosis. Molecular analysis showed that she was coinfected by 2 MTB isolates. The coinfecting isolates showed only subtle genetic differences and shared equivalent infectivity in vitro; however, they were infecting independent anatomic sites (compartmentalized infection). One of the MTB isolates was cultured only from respiratory specimens, whereas the other was isolated from extrarespiratory site (central nervous system).
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ranking = 48.91375421806
keywords = mycobacterium
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4/10. Drug resistant tuberculous meningitis in the philippines: report of a case.

    A fatal case of tuberculous meningitis caused by a multiply-resistant tubercle bacillus is described, the first such case from Southeast asia. Increased efforts to isolate mycobacterium tuberculosis from the cerebrospinal fluid and determine the extent and pattern of drug resistance are necessary if the high mortality from this disease is to be reduced.
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ranking = 2.2067402483973
keywords = bacillus
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5/10. Tuberculous meningitis due to BCG in two previously healthy children.

    Tuberculous meningitis with favourable outcome has been observed in two immunocompetent previously healthy children. The mycobacteria isolated from the cerebrospinal fluid of both patients proved to be mycobacterium bovis BCG. The patients had been inoculated with BCG, one 5 and the other 6 months before onset of the disease.
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ranking = 1
keywords = bovis
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6/10. mycobacterium tuberculosis meningitis: a report of twelve cases and a literature review.

    Twelve recent cases of mycobacterium tuberculosis meningitis were presented, and the literature was reviewed. There are no particularly new or unique therapies or approaches to the management of this most serious disease. The major obstacle to successful diagnosis and treatment of tuberculous meningitis continues to be a lack of clinical suspicion of its presence. As illustrated in the cases presented, it has been our experience that patients already moribund or nonresponsive do not respond, regardless of the intervention undertaken. The most sensitive and economical method of detecting M. tuberculosis in the CSF may be LPA. However, this has not yet been widely validated or accepted. Larger volumes of CSF should be sent to the laboratory for testing and centifuged to about 5x concentrations before both acid-fast bacilli staining and culture are attempted. If tuberculous meningitis is suspected, three-drug therapy can be started immediately without jeopardizing subsequent culture confirmation of the presence of the TB bacillus. In addition, these patients must be followed closely to detect hydrocephalus at the earliest possible moment. When patients fail to respond to appropriate antituberculosis and pressure-reducing therapy, hydrocephalus should be actively sought by either CT or radioisotope cisternography. Although the decision to proceed to ventricular drainage or shunting must be individually made in adult patients with infection-related hydrocephalus, we agree with others that surgical intervention should be considered early and should be performed if the level of consciousness deteriorates, intracranial pressure increases, or ventricular enlargement or enhancing basal exudates are identified on CT.
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ranking = 2.2067402483973
keywords = bacillus
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7/10. Tuberculous meningitis due to mycobacterium bovis: a report of two cases.

    Two Caucasian patients with bovine tuberculous meningitis are described. Classical mycobacterium bovis was isolated from the cerebrospinal fluid on both occasions. Despite the elimination of cattle tuberculosis in this country, reactivated primary disease due to the bovine tubercle bacillus may still occur.
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ranking = 7.2067402483973
keywords = bacillus, bovis
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8/10. A case of disseminated mycobacterium bovis infection in an AIDS patient.

    The first case of disseminated mycobacterium bovis infection with meningitis in an AIDS patient is reported. A 54-year-old male hiv-positive patient was admitted for evaluation of fever, weight loss, inappetence, fatigue and malaise. mycobacterium bovis (non-BCG) was isolated from blood, bone marrow, stool, urine, sputum, abdominal lymph nodes and cerebrospinal fluid. Antituberculous therapy using a five-drug regimen plus steroids resulted in complete recovery.
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ranking = 6
keywords = bovis
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9/10. Isolated meningeal tuberculoma mimicking meningioma: case report.

    A 47-year-old German female patient is described with intracranial tuberculoma of the dura mater without history or evidence of tuberculosis and a negative tuberculin reaction. Computed tomography and magnetic resonance imaging and angiography resembled a meningioma. diagnosis was verified by histology and identification of mycobacterium tuberculosis. After removal of the granuloma and high-dose chemotherapy, the patient was free of disease. tuberculoma of the dura mater is an extremely rare disease in the Western European population.
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ranking = 12.228438554515
keywords = mycobacterium
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10/10. Intracranial tuberculous subdural empyema: case report.

    OBJECTIVE AND IMPORTANCE: Many types of neurotuberculosis have been described; the most common intracranial forms are tuberculous meningitis and tuberculomas. We report a unique and as yet unreported form of neurotuberculosis, which is an intracranial tuberculous subdural empyema. CLINICAL PRESENTATION: A 59-year-old man who had been previously treated for pulmonary tuberculosis (TB) presented at our institution with a long-standing history of headaches. General and neurological examinations revealed no abnormalities. radiography of the chest confirmed fibrotic lung changes caused by healed pulmonary TB. A cranial computed tomographic scan revealed a hypodense extra-axial collection with mass effect as well as adjacent osteitis and scalp swelling. INTERVENTION: The patient underwent craniectomy of the osteitic bone and drainage of 50 ml of fluid pus located subdurally. Microscopic examination of the bone and pus revealed tuberculous granulation tissue with numerous acid-fast bacilli identified using Ziehl-Neelsen stain. Mycobacterium TB bacillus was cultured from the pus at 42 days. The patient required two further operative procedures as well as a protracted course of anti-TB therapy. CONCLUSION: The patient eventually achieved a good recovery. We recommend surgical drainage of tuberculous subdural empyema to relieve mass effect and to obtain microbiological confirmation. Furthermore, surgical treatment should be combined with an 18-month course of anti-TB chemotherapy, during which period patient compliance should be closely monitored.
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ranking = 2.2067402483973
keywords = bacillus
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