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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Update on the diagnosis and management of tuberculous meningitis in children
Seminars in Pediatric Neurology, Volume 21, No. 1, Year 2014
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Description
Tuberculous meningitis (TBM), the most devastating manifestation of tuberculosis, is often missed or overlooked because of nonspecific symptoms and difficulties in diagnosis. It continues to be an important cause of neurologic handicap in resource-poor countries. Owing to the suboptimal performance of diagnostic tests of TBM, diagnosis relies on thorough history, clinical examination, and relevant investigations. The development of affordable, accurate diagnostic tests for TBM in resource-poor settings remains a priority. Short intensified treatment is safe and effective in both human immunodeficiency virus (HIV)-infected and HIV-uninfected children. Treatment of tuberculous hydrocephalus depends on the level of the cerebrospinal fluid obstruction. Corticosteroids reduce risk of neurodisability and death in HIV-uninfected children. Thalidomide should be considered in children compromised by tuberculosis abscesses and tuberculous-related optochiasmic arachnoiditis. In resource-poor countries, home-based TBM treatment after initial in-hospital stabilization is feasible in carefully selected patients. Early diagnosis and treatment of TBM is the single most important factor determining outcome. © 2014 Elsevier Inc.
Authors & Co-Authors
van Toorn, Ronald
South Africa, Stellenbosch
Stellenbosch University
Solomons, Regan S.
South Africa, Stellenbosch
Stellenbosch University
Statistics
Citations: 58
Authors: 2
Affiliations: 1
Identifiers
Doi:
10.1016/j.spen.2014.01.006
ISSN:
10719091
e-ISSN:
15580776
Research Areas
Health System And Policy
Infectious Diseases
Maternal And Child Health