Clinical Management of Pathogen-Negative Tuberculous Meningitis in Adults: A Series Case Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Recruitment
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Data Collection
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Variables | Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | ||
---|---|---|---|---|---|---|---|
Age | 27 | 56 | 48 | 40 | 62 | ||
Sex | Male | Male | Male | Male | Female | ||
Potentially relevant personal history | Eats seafood | Neighbors have pigeons | Breakfast shop owner | Construction worker | Retiree | ||
Exposure history of tuberculosis | Yes | No | No | No | No | ||
Illness history | No | No | No | No | No | ||
History of Smoke/Drink/Drug | No | No | No | No | No | ||
Symptom duration (days) | 29 | 14 | 11 | 19 | 12 | ||
Prodrome | Cold and cough | Cold and anorexia | Toothache and muscle soreness and anorexia | Diarrhea and fatigue | Cold | ||
Clinical syndrome | Headache | Yes | Yes | Yes | Yes | Yes | |
Fever | Yes | Yes | Yes | Yes | Yes | ||
Night sweat | Yes | No | Yes | No | No | ||
Hyponatremia | Yes | No | Yes | No | Yes | ||
Cranial nerve palsy symptoms | intractable hiccup | No | No | No | No | ||
Altered consciousness | Lethargy | Psychiatric symptoms and cognitive impairment | Lethargy | No | Epileptic seizures | ||
Stiff-Neck | Yes | Yes | Yes | Yes | Yes | ||
Laboratory results | CSF Specimen | M. tb culture | − | − | − | − | - |
ZN smear | − | − | − | − | - | ||
mNGS | − | − | − | Human M.tb | - | ||
Xpert | − | − | − | − | - | ||
Bacterial culture | − | − | − | − | - | ||
Bacterial staining | − | − | − | − | - | ||
India ink staining | − | − | − | − | - | ||
Virus antibody * | − | / | − | − | - | ||
Ab related to AE * | − | / | / | / | - | ||
WCC * (106/L) | 350 | 510 | 134 | 250 | 125 | ||
Protein * (mg/L) | 1383 | 1683 | 2356 | 1260 | 819 | ||
Glucose * (mmol/L) | 1.38 | 2.08 | 1.96 | 1.51 | 2.15 | ||
Blood specimen | Fungal antigen * | + | − | − | − | - | |
Virus antibody * | − | / | − | − | - | ||
mNGS | − | − | − | − | - | ||
T-SPOT | + | + | + | + | - | ||
ANA | − | / | / | / | / | ||
Evidence of extracranial tuberculosis | Chest-CT | - | − | − | − | − | |
Cervical Spinal cord MRI | - | − | − | / | − | ||
ATT time(days) | 30 | 15 | 12 | 20 | 31 | ||
Follow up time(months) | 8 | 3 | 6 | 6 | 3 | ||
Neurological sequelae | No | No | No | No | No |
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He, Y.; Huang, Y.; Wu, D.; Wu, Y.; Wang, M. Clinical Management of Pathogen-Negative Tuberculous Meningitis in Adults: A Series Case Study. J. Clin. Med. 2022, 11, 6250. https://doi.org/10.3390/jcm11216250
He Y, Huang Y, Wu D, Wu Y, Wang M. Clinical Management of Pathogen-Negative Tuberculous Meningitis in Adults: A Series Case Study. Journal of Clinical Medicine. 2022; 11(21):6250. https://doi.org/10.3390/jcm11216250
Chicago/Turabian StyleHe, Yuqin, Yanzhu Huang, Di Wu, Yingying Wu, and Minghuan Wang. 2022. "Clinical Management of Pathogen-Negative Tuberculous Meningitis in Adults: A Series Case Study" Journal of Clinical Medicine 11, no. 21: 6250. https://doi.org/10.3390/jcm11216250