Abstract
Nineteen cases with tuberculous meningitis were included in this study who were treated in Atatürk University Medical School Pediatrics Clinic between January 1991-1994. The mean age of the patients was 55.5± 31.7 months and 68.4% were females. The symptoms were fever(89.5%), vomiting(57.9%)and lethargy (42.1%). Family history was positive in eight cases (42.1%) and tuberculin skin test was positive in four cases (10.5%). The mean cerebrospinal fluid protein (CSF) level was 160mg/dl, CSF/serum glucose ratio was 30.8% and CSF leucocyte count was 148/mm. Chest radiographs were positive in 11 cases (57.9%). Twelve patients had computerized cranial tomography and hydrocephalus was demonstrated in seven (58.3%) of these patients. Adenosine deaminase activity was determined in six cases and all were high (33.4 ±4.7 U/L). The diagnosis of tuberculous menengitis was confirmed by polymerase chain reaction in four cases. Mycobacterium tuberculosis culture was positive in five of the nineteen cases. At admission two (10.5 %) cases were in Stage I, eight (42.1%) were in Stage II, and nine (47.4%) were in Stage III. Mortality ratio was 47.4% and it was highest in Stage III. Key words: Tuberculous meningitis, clinical findings, mortality
Abstract
Bu çalışma Atatürk Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğinde Ocak 1991-Ocak 1994 tarihleri arasında yatırılarak izlenen 19 tüberküloz menenjitli olgu üzerinde gerçekleştirildi. Olguların ortalama yaşı 55.5 ± 31.7 ay olup %68.4'ü kız idi. En sık görülen şikayetler ateş (%89.5), kusma (%57.9), ve dalgınlık (%42.1) idi. Sekiz olguda (%42.1) pozitif aile öyküsü, dört (%10.5) olguda PPD pozitifliği tesbit edildi. Başvurudaki ortalama beyin omurilik (BOS) protein düzeyi 160 mg/dl, BOS/serum glukoz oram %30.8, BOS lökosit sayısı 148/mm3 ve % lenfosit 69±16 (25-100) bulunmuştur. 11 hastada (%57.9) tüberküloz lehine akciğer grafisi bulguları saptandı. 12 olguya bilgisayarlı beyin tomografisi(BBT) çektirilebildi, yedi(%58.3)'sinde hidrosefali tesbit edildi. Altı olguda bakılan adenozin deaminaz (ADA) seviyesi yüksekti (33.4+4.7 U/L) dört olgunun tanısı da polimeraz zincir reaksiyonu (PCR) ile doğrulandı. Beş hastada kültürde Mycobacterium Tuberculosis üredi. Başvuru esnasında iki (%10.5) olgu Evre I, sekiz (%42.1) olgu Evre II. dokuz (%47.4) olgu ise Evre III olup mortalite oranı %47.4 idi. Evre l'de sekel oranı % 100 iken Evre ll'de % 57.1 olarak bulundu. Tüberküloz menenenjitte mortalite ve morbiditeyi azaltmak açısından erken tanının önemi vurgulandı. Anahtar kelimeler: Tüberküloz menenjit, klinik bulgular, mortalite
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Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | February 1, 1996 |
| Published in Issue | Year 1996 Volume: 3 Issue: 1 |