The Clinical Characteristics of Hospitalized Tuberculous Meningitis in Tosei General Hospital, 2012-2022
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- SAITO Sachiko
- Department of Infectious Diseases, Tosei General Hospital
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- MUTOH Yoshikazu
- Department of Infectious Diseases, Tosei General Hospital
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- UMEMURA Takumi
- Department of Infectious Diseases, Tosei General Hospital
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- ICHIHARA Toshihiko
- Department of Infectious Diseases, Tosei General Hospital
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- KIMURA Tomoki
- Department of Respiratory Medicine and Allergy, Tosei General Hospital
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- YUASA Hiroyuki
- Department of Neurology, Tosei General Hospital
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- KONDOH Yasuhiro
- Department of Respiratory Medicine and Allergy, Tosei General Hospital
Bibliographic Information
- Other Title
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- 過去10年間に当院に入院した結核性髄膜炎の臨床的検討
Abstract
<p>Tuberculosis meningitis (TBM) is associated with significant neurological sequelae and a high mortality rate. Recent research shows a low incidence of tuberculosis in Japan; however, a few physicians have been encountering cases of TBM in clinical practice. Therefore, deeper understanding of the clinical features and disease course is important. In this study, we retrospectively investigated patients hospitalized with diagnosis of TBM at Tosei General Hospital, Seto, Japan between 2012 and 2022. Patient data including age, sex, nationalities, medical histories, initial symptoms, site of infection, major findings on brain magnetic resonance imaging (MRI), blood and cerebrospinal fluid (CSF) investigation findings, treatment, and prognosis were obtained from medical records. In total of 14 cases, mean age was 70.5 years [standard deviation 18.0 years], 6 (42.9%) were women, and 13 (92.9%) were Japanese. The most common site of active tuberculosis infection was the lungs. Disseminated tuberculosis was observed in 12 (85.7%) and urinary tract tuberculosis in 8 (66.7%) patients. Clinical symptoms on admission included headache in 6 (42.9%), systemic symptoms in 6 (42.9%), fever in 3 (21.4%), convulsions in 1 (7.1%), weight loss in 1 (7.1%), and dyspnea in 1 (7.1%) patient. Major findings on brain MRI were cerebral infarction in 5 (35.7%), tuberculomas in 5 (35.7%), and hydrocephalus in 1 (7.1%) patient. CSF analysis confirmed bacterial infection in 3 (21.4%) patients. All patients received antituberculosis drugs, and corticosteroid was administered to 12 (85.7%) patients. Median length of hospitalization was 71.5 days (interquartile range 36.81-10.5 days), 8 (57.1%) patients recovered with sequelae, 4 (28.6%) died, and 2 (14.3%) patients recovered completely. In conclusion, TBM is diagnostically challenging based on CSF analysis, and careful evaluation of symptoms, imaging findings, and the clinical course are important for accurate diagnosis. Further studies are warranted to gain deeper insight into TBM.</p>
Journal
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- Kansenshogaku Zasshi
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Kansenshogaku Zasshi 98 (1), 1-7, 2024-01-20
The Japanese Association for Infectious Diseases
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Details 詳細情報について
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- CRID
- 1390298897680469632
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- ISSN
- 1884569X
- 03875911
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed