Abstract

MONTIEL-BLANCO, Johnny D. et al. Meningial Tuberculosis in children: Experience in the Instituto Nacional de Salud del Niño from Lima, 2009-2013. Rev Neuropsiquiatr [online]. 2015, vol.78, n.1, pp.14-21. ISSN 0034-8597.

Objectives: To describe clinical, epidemiological, laboratory and neuro imaging characteristics of children with Meningeal Tuberculosis (MEC TBC) at the Instituto Nacional de Salud del Niño, in Lima, Peru. Methods: Retrospective, descriptive case series from January 2009 to September 2013. Results: 31 cases with MEC TBC were included, with a frequency of 7.4 cases per year. The average age was7.3 years and boy/girl rate was 1.2. The more frequent characteristics were the malnutrition, a positive TBC contact and pulmonary TBC. The most common clinical findings were fever, vomits, altered consciousness and meningeal signs. Most cases were in the II clinical state of the disease (83.9%) and the majority evolved with severe complications (51.6%). The cerebrospinal fluid (CSF) findings showed an average 275.6 cells/mm3 cells and median of 184 cells/mm3 (15-1364 cells/mm3). The Koch bacillus was identified in 19.5 % of the CSF culture. The more frequent imaging findings were hydrocephalus (58%), cerebral infarct and granuloma. Six children with hydrocephalus needed a cerebral peritoneal shunt and five children evolved with a paradoxical reaction. The mortality was 12.9%. Conclusions: The hospital incidence was 7.4 cases per year, most of them came in stage II of the disease and left with major sequela, the hydrocephalus was the most frequent imaging finding and the mortality was 12.9%.

Keywords : Meningoencephalitis; meningitis; tuberculous; children.

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