ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2022. Global Tuberculosis Report 2022. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240061729. Accessed April 18, 2023.
-
2.
Houben RM , Dodd PJ , 2016. The global burden of latent tuberculosis infection: A re-estimation using mathematical modelling. PLoS Med 13: e1002152.
-
3.
Schoeman JF , Donald PR , 2013. Tuberculous meningitis. Handb Clin Neurol 112: 1135–1138.
-
4.
Navarro-Flores A , Fernandez-Chinguel JE , Pacheco-Barrios N , Soriano-Moreno DR , Pacheco-Barrios K , 2022. Global morbidity and mortality of central nervous system tuberculosis: A systematic review and meta-analysis. J Neurol 269: 3482–3494.
-
5.
Watch V , Aipit J , Kote-Yarong T , Rero A , Bolnga JW , Lufele E , Laman M , 2017. The burden of presumed tuberculosis in hospitalized children in a resource-limited setting in Papua New Guinea: A prospective observational study. Int Health 9: 374–378.
-
6.
Misra UK , Kalita J , Srivastava M , Mandal SK , 1996. Prognosis of tuberculous meningitis: A multivariate analysis. J Neurol Sci 137: 57–61.
-
7.
Kalita J , Misra UK , Singh VK , Pandey PC , Thomas J , 2020. Inclusion of mechanical ventilation in severity staging of tuberculous meningitis improves outcome prediction. Am J Trop Med Hyg 103: 689–695.
-
8.
Modi M et al., 2017. Clinical and radiological predictors of outcome in tubercular meningitis: A prospective study of 209 patients. Clin Neurol Neurosurg 161: 29–34.
-
9.
Hosoglu S et al., 2002. Predictors of outcome in patients with tuberculous meningitis. Int J Tuberc Lung Dis 6: 64–70.
-
10.
Buonsenso D , Serranti D , Valentini P , 2010. Management of central nervous system tuberculosis in children: Light and shade. Eur Rev Med Pharmacol Sci 14: 845–853.
-
11.
Misra UK , Kalita J , Srivastava R , Nair PP , Mishra MK , Basu A , 2010. A study of cytokines in tuberculous meningitis: Clinical and MRI correlation. Neurosci Lett 483: 6–10.
-
12.
Lin TY , Nelson JD , McCracken GH Jr , 1984. Fever during treatment for bacterial meningitis. Pediatr Infect Dis 3: 319–322.
-
13.
Rutman DL , Wald ER , 1981. Fever in Haemophilus influenzae type B meningitis. Clin Pediatr (Phila) 20: 192–195.
-
14.
Daoud AS , Zaki M , al-Saleh QA , 1989. Prolonged and secondary fever in childhood bacterial meningitis. Eur J Pediatr 149: 114–116.
-
15.
Yassin Z , Ahmadinejad Z , Kouchak HE , 2016. The fever response after treatment of tuberculosis: What is the expected time and what are the risk factors? J Infect Dis Treat 2: 1.
-
16.
Tsao TC , Tsai YH , Lan RS , Shieh WB , Lee CH , 1989. Fever characteristics in tuberculosis—clinical observation in 597 cases. Changge-ng Yi-xue Zazhi 12: 81–88.
-
17.
Barnes PF , Chan LS , Wong SF , 1987. The course of fever during treatment of pulmonary tuberculosis. Tubercle 68: 255–260.
-
18.
Kalita J , Pandey PC , Shukla R , Haldar R , 2022. Predictors of fever response in tuberculous meningitis: A clinical, MRI and biomarker study. Eur J Clin Invest 52: e13701.
-
19.
Marais S , Thwaites G , Schoeman JF , Török ME , Misra UK , Prasad K , Donald PR , Wilkinson RJ , Marais BJ , 2010. Tuberculous meningitis: A uniform case definition for use in clinical research. Lancet Infect Dis 10: 803–812.
-
20.
Misra UK , Kalita J , Roy AK , Mandal SK , Srivastava M , 2000. Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: A multivariable analysis. J Neurol Neurosurg Psychiatry 68: 300–303.
-
21.
British Medical Research Council , 1948. Streptomycin in tuberculosis trials committee: Streptomycin treatment of tuberculous meningitis. Lancet 1: 582–596.
-
22.
Misra Usha K , 2018. Jayantee Kalita, Mritunjai Kumar. Safety and efficacy of fludrocortisone in the treatment of cerebral salt wasting in patients with tuberculous meningitis: A randomized clinical trial. JAMA Neurol 75: 1383–1391.
-
23.
El-Radhi AS & El-Radhi A Clinical Manual of Fever in Children. Cham: Springer, 53–68.
-
24.
Stefferl A , Hopkins SJ , Rothwell NJ , Luheshi GN , 1996. The role of TNF-alpha in fever: Opposing actions of human and murine TNF-alpha and interactions with IL-beta in the rat. Br J Pharmacol 118: 1919–1924.
-
25.
Derijk RH , Berkenbosch F , 1994. Hypothermia to endotoxin involves the cytokine tumor necrosis factor and the neuropeptide vasopressin in rats. Am J Physiol 266: R9–R14.
-
26.
Le May LG , Vander AJ , Kluger MJ , 1990. Role of interleukin 6 in fever in rats. Am J Physiol 258: R798–R803.
-
27.
Raut T , Garg RK , Jain A , Verma R , Singh MK , Malhotra HS , Kohli N , Parihar A , 2013. Hydrocephalus in tuberculous meningitis: Incidence, its predictive factors and impact on the prognosis. J Infect 66: 330–337.
-
28.
Andronikou S , Smith B , Haverhill M , Douis H , Wilmshurst J , 2004. Definitive neuroradiological diagnostic features of tuberculous meningitis in children. Pediatr Radiol 34: 876–885.
-
29.
Chow E , Troy SB , 2014. The differential diagnosis of hypoglycorrhachia in adult patients. Am J Med Sci 348: 186–190.
-
30.
Nuwagira E et al., 2022. Diagnostic and prognostic value of cerebrospinal fluid lactate and glucose in HIV-associated tuberculosis meningitis. Microbiol Spectr 10: e0161822.
-
31.
Pieters J , 2008. Mycobacterium tuberculosis and the macrophage: Maintaining a balance. Cell Host Microbe 3: 399–407.
-
32.
Lipiridou O , Lazaridou S , Manios S , 1973. Recurrent and persistent fever in bacterial meningitis with an adequate response to antimicrobial therapy. Scand J Infect Dis 5: 23–27.
-
33.
Thwaites GE , Chau TT , Stepniewska K , Phu NH , Chuong LV , Sinh DX , White NJ , Parry CM , Farrar JJ , 2002. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 360: 1287–1292.
-
34.
Sunbul M , Atilla A , Esen S , Eroglu C , Leblebicioglu H , 2005. Thwaites’ diagnostic scoring and the prediction of tuberculous meningitis. Med Princ Pract 14: 151–154.
-
35.
Török ME et al., 2007. Validation of a diagnostic algorithm for adult tuberculous meningitis. Am J Trop Med Hyg 77: 555–559.
-
36.
Vibha D , Bhatia R , Prasad K , Srivastava MV , Tripathi M , Kumar G , Singh MB , 2012. Validation of a diagnostic algorithm to differentiate between tuberculous meningitis and acute bacterial meningitis. Clin Neurol Neurosurg 114: 639–644.
-
37.
Yang Y , Qu XH , Zhang KN , Wu XM , Wang XR , Wen A , Li LJ , 2020. A diagnostic formula for discrimination of tuberculous and bacterial meningitis using clinical and laboratory features. Front Cell Infect Microbiol 9: 448.
-
38.
Misra UK , Kalita J , Roy AK , Mandal SK , Srivastava M , 2000. Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: A multivariable analysis. J Neurol Neurosurg Psychiatry 68: 300–303.
-
39.
Thwaites GE , van Toorn R , Schoeman J , 2013. Tuberculous meningitis: More questions, still too few answers. Lancet Neurol 12: 999–1010.
-
40.
Kalita J , Shukla R , Pandey PC , Misra UK , 2022. Balancing between apoptosis and survival biomarkers in the patients with tuberculous meningitis. Cytokine 157: 155960.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 467 | 467 | 216 |
| Full Text Views | 19 | 19 | 7 |
| PDF Downloads | 28 | 28 | 15 |
Predictors of Resolution of Meningitis Symptoms in Tuberculous Meningitis: A Clinical, Magnetic Resonance Imaging, and Biomarker Study
Prakash C. Pandey
Prakash C. Pandey
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India
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Jayantee Kalita
Jayantee Kalita
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India
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Ruchi Shukla
Ruchi Shukla
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India
Search for other papers by Ruchi Shukla in
Current site
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PubMed
Search for other papers by Ruchi Shukla in
Current site
Google Scholar
PubMed
ABSTRACT.
In tuberculous meningitis (TBM), the meningeal symptoms and their resolution after treatment may be dependent on clinical-radiological severity, cerebrospinal fluid (CSF), and proinflammatory cytokines, and these findings may be associated with outcome. There is a paucity of studies on the resolution of meningitis symptoms in TBM. We report on associations of clinical, magnetic resonance imaging (MRI), laboratory, and proinflammatory cytokines [tumor necrosis factor (TNF)-α and interleukin 6 (IL-6)] findings with the resolution of meningitis symptoms (RMS), and the impact of RMS duration on the outcome in TBM. Seventy-one patients with TBM were included, and their clinical, laboratory, and MRI findings at baseline were recorded. mRNA profiling of TNF-α and IL-6 was done by reverse transcriptase polymerase chain reaction. The day of RMS (fever, headache, and vomiting) after treatment was noted. Predictors of long duration of RMS (>3 weeks) were evaluated by univariate followed by multivariate analysis. The impact of RMS on 6-month mortality and outcome was analyzed. Patients’ median age was 25 years, and 45 (63.4%) were males. After antitubercular treatment, meningeal symptoms resolved in 35 (50.70%) by 21 days and in 90% of patients by 49 days. Longer time of RMS was associated with TBM stage, pretreatment duration, seizure, and hydrocephalus but not with TNF-α and IL-6. Seven (9.8%) patients died at 6 months, and duration of RMS predicted death (hazard ratio = 25.55, 95% CI: 1.108–589.40; P = 0.04).
Author Notes
Financial support: This study was supported by
Disclosure: The Institute Ethics Committee of Sanjay Gandhi Post Graduate Institute of Medical Sciences approved the study protocol (2018-28-IMP-102). Patients or their guardians consented to the study.
Current contact information: Prakash C. Pandey, Jayantee Kalita, and Ruchi Shukla, Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh, India, E-mails: drprakashpandey@gmail.com, jayanteek@yahoo.com, and shuklaruchi738@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
World Health Organization , 2022. Global Tuberculosis Report 2022. Geneva, Switzerland: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240061729. Accessed April 18, 2023.
-
2.
Houben RM , Dodd PJ , 2016. The global burden of latent tuberculosis infection: A re-estimation using mathematical modelling. PLoS Med 13: e1002152.
-
3.
Schoeman JF , Donald PR , 2013. Tuberculous meningitis. Handb Clin Neurol 112: 1135–1138.
-
4.
Navarro-Flores A , Fernandez-Chinguel JE , Pacheco-Barrios N , Soriano-Moreno DR , Pacheco-Barrios K , 2022. Global morbidity and mortality of central nervous system tuberculosis: A systematic review and meta-analysis. J Neurol 269: 3482–3494.
-
5.
Watch V , Aipit J , Kote-Yarong T , Rero A , Bolnga JW , Lufele E , Laman M , 2017. The burden of presumed tuberculosis in hospitalized children in a resource-limited setting in Papua New Guinea: A prospective observational study. Int Health 9: 374–378.
-
6.
Misra UK , Kalita J , Srivastava M , Mandal SK , 1996. Prognosis of tuberculous meningitis: A multivariate analysis. J Neurol Sci 137: 57–61.
-
7.
Kalita J , Misra UK , Singh VK , Pandey PC , Thomas J , 2020. Inclusion of mechanical ventilation in severity staging of tuberculous meningitis improves outcome prediction. Am J Trop Med Hyg 103: 689–695.
-
8.
Modi M et al., 2017. Clinical and radiological predictors of outcome in tubercular meningitis: A prospective study of 209 patients. Clin Neurol Neurosurg 161: 29–34.
-
9.
Hosoglu S et al., 2002. Predictors of outcome in patients with tuberculous meningitis. Int J Tuberc Lung Dis 6: 64–70.
-
10.
Buonsenso D , Serranti D , Valentini P , 2010. Management of central nervous system tuberculosis in children: Light and shade. Eur Rev Med Pharmacol Sci 14: 845–853.
-
11.
Misra UK , Kalita J , Srivastava R , Nair PP , Mishra MK , Basu A , 2010. A study of cytokines in tuberculous meningitis: Clinical and MRI correlation. Neurosci Lett 483: 6–10.
-
12.
Lin TY , Nelson JD , McCracken GH Jr , 1984. Fever during treatment for bacterial meningitis. Pediatr Infect Dis 3: 319–322.
-
13.
Rutman DL , Wald ER , 1981. Fever in Haemophilus influenzae type B meningitis. Clin Pediatr (Phila) 20: 192–195.
-
14.
Daoud AS , Zaki M , al-Saleh QA , 1989. Prolonged and secondary fever in childhood bacterial meningitis. Eur J Pediatr 149: 114–116.
-
15.
Yassin Z , Ahmadinejad Z , Kouchak HE , 2016. The fever response after treatment of tuberculosis: What is the expected time and what are the risk factors? J Infect Dis Treat 2: 1.
-
16.
Tsao TC , Tsai YH , Lan RS , Shieh WB , Lee CH , 1989. Fever characteristics in tuberculosis—clinical observation in 597 cases. Changge-ng Yi-xue Zazhi 12: 81–88.
-
17.
Barnes PF , Chan LS , Wong SF , 1987. The course of fever during treatment of pulmonary tuberculosis. Tubercle 68: 255–260.
-
18.
Kalita J , Pandey PC , Shukla R , Haldar R , 2022. Predictors of fever response in tuberculous meningitis: A clinical, MRI and biomarker study. Eur J Clin Invest 52: e13701.
-
19.
Marais S , Thwaites G , Schoeman JF , Török ME , Misra UK , Prasad K , Donald PR , Wilkinson RJ , Marais BJ , 2010. Tuberculous meningitis: A uniform case definition for use in clinical research. Lancet Infect Dis 10: 803–812.
-
20.
Misra UK , Kalita J , Roy AK , Mandal SK , Srivastava M , 2000. Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: A multivariable analysis. J Neurol Neurosurg Psychiatry 68: 300–303.
-
21.
British Medical Research Council , 1948. Streptomycin in tuberculosis trials committee: Streptomycin treatment of tuberculous meningitis. Lancet 1: 582–596.
-
22.
Misra Usha K , 2018. Jayantee Kalita, Mritunjai Kumar. Safety and efficacy of fludrocortisone in the treatment of cerebral salt wasting in patients with tuberculous meningitis: A randomized clinical trial. JAMA Neurol 75: 1383–1391.
-
23.
El-Radhi AS & El-Radhi A Clinical Manual of Fever in Children. Cham: Springer, 53–68.
-
24.
Stefferl A , Hopkins SJ , Rothwell NJ , Luheshi GN , 1996. The role of TNF-alpha in fever: Opposing actions of human and murine TNF-alpha and interactions with IL-beta in the rat. Br J Pharmacol 118: 1919–1924.
-
25.
Derijk RH , Berkenbosch F , 1994. Hypothermia to endotoxin involves the cytokine tumor necrosis factor and the neuropeptide vasopressin in rats. Am J Physiol 266: R9–R14.
-
26.
Le May LG , Vander AJ , Kluger MJ , 1990. Role of interleukin 6 in fever in rats. Am J Physiol 258: R798–R803.
-
27.
Raut T , Garg RK , Jain A , Verma R , Singh MK , Malhotra HS , Kohli N , Parihar A , 2013. Hydrocephalus in tuberculous meningitis: Incidence, its predictive factors and impact on the prognosis. J Infect 66: 330–337.
-
28.
Andronikou S , Smith B , Haverhill M , Douis H , Wilmshurst J , 2004. Definitive neuroradiological diagnostic features of tuberculous meningitis in children. Pediatr Radiol 34: 876–885.
-
29.
Chow E , Troy SB , 2014. The differential diagnosis of hypoglycorrhachia in adult patients. Am J Med Sci 348: 186–190.
-
30.
Nuwagira E et al., 2022. Diagnostic and prognostic value of cerebrospinal fluid lactate and glucose in HIV-associated tuberculosis meningitis. Microbiol Spectr 10: e0161822.
-
31.
Pieters J , 2008. Mycobacterium tuberculosis and the macrophage: Maintaining a balance. Cell Host Microbe 3: 399–407.
-
32.
Lipiridou O , Lazaridou S , Manios S , 1973. Recurrent and persistent fever in bacterial meningitis with an adequate response to antimicrobial therapy. Scand J Infect Dis 5: 23–27.
-
33.
Thwaites GE , Chau TT , Stepniewska K , Phu NH , Chuong LV , Sinh DX , White NJ , Parry CM , Farrar JJ , 2002. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 360: 1287–1292.
-
34.
Sunbul M , Atilla A , Esen S , Eroglu C , Leblebicioglu H , 2005. Thwaites’ diagnostic scoring and the prediction of tuberculous meningitis. Med Princ Pract 14: 151–154.
-
35.
Török ME et al., 2007. Validation of a diagnostic algorithm for adult tuberculous meningitis. Am J Trop Med Hyg 77: 555–559.
-
36.
Vibha D , Bhatia R , Prasad K , Srivastava MV , Tripathi M , Kumar G , Singh MB , 2012. Validation of a diagnostic algorithm to differentiate between tuberculous meningitis and acute bacterial meningitis. Clin Neurol Neurosurg 114: 639–644.
-
37.
Yang Y , Qu XH , Zhang KN , Wu XM , Wang XR , Wen A , Li LJ , 2020. A diagnostic formula for discrimination of tuberculous and bacterial meningitis using clinical and laboratory features. Front Cell Infect Microbiol 9: 448.
-
38.
Misra UK , Kalita J , Roy AK , Mandal SK , Srivastava M , 2000. Role of clinical, radiological, and neurophysiological changes in predicting the outcome of tuberculous meningitis: A multivariable analysis. J Neurol Neurosurg Psychiatry 68: 300–303.
-
39.
Thwaites GE , van Toorn R , Schoeman J , 2013. Tuberculous meningitis: More questions, still too few answers. Lancet Neurol 12: 999–1010.
-
40.
Kalita J , Shukla R , Pandey PC , Misra UK , 2022. Balancing between apoptosis and survival biomarkers in the patients with tuberculous meningitis. Cytokine 157: 155960.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 467 | 467 | 216 |
| Full Text Views | 19 | 19 | 7 |
| PDF Downloads | 28 | 28 | 15 |