دورية أكاديمية
أعرض في EDS

Clinical and microbiological features of HIV-associated tuberculous meningitis in Vietnamese adults.

التفاصيل البيبلوغرافية
العنوان: Clinical and microbiological features of HIV-associated tuberculous meningitis in Vietnamese adults.
المؤلفون: Torok ME; Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam. etorok@oucru.org, Chau TT, Mai PP, Phong ND, Dung NT, Chuong LV, Lee SJ, Caws M, de Jong MD, Hien TT, Farrar JJ
المصدر: PloS one [PLoS One] 2008 Mar 19; Vol. 3 (3), pp. e1772. Date of Electronic Publication: 2008 Mar 19.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: Electronic Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: AIDS-Related Opportunistic Infections/*microbiology , AIDS-Related Opportunistic Infections/*pathology , Tuberculosis, Meningeal/*microbiology , Tuberculosis, Meningeal/*pathology, AIDS-Related Opportunistic Infections/complications ; AIDS-Related Opportunistic Infections/drug therapy ; AIDS-Related Opportunistic Infections/epidemiology ; Adult ; Antitubercular Agents/administration & dosage ; Antitubercular Agents/therapeutic use ; Cohort Studies ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Tuberculosis, Meningeal/complications ; Tuberculosis, Meningeal/drug therapy ; Tuberculosis, Meningeal/epidemiology ; Vietnam/epidemiology
مستخلص: Methods: The aim of this prospective, observational cohort study was to determine the clinical and microbiological features, outcome, and baseline variables predictive of death, in Vietnamese adults with HIV-associated tuberculous meningitis (TBM). 58 patients were admitted to the Hospital for Tropical Diseases in Ho Chi Minh City and underwent routine clinical and laboratory assessments. Treatment was with standard antituberculous therapy and adjunctive dexamethasone; antiretroviral therapy was not routinely available. Patients were followed up until the end of TB treatment or death.
Results: The median symptom duration was 11 days (range 2-90 days), 21.8% had a past history of TB, and 41.4% had severe (grade 3) TBM. The median CD4 count was 32 cells/mm(3). CSF findings were as follows: median leucocyte count 438 x 10(9)cells/l (63% neutrophils), 69% smear positive and 87.9% culture positive. TB drug resistance rates were high (13% mono-resistance 32.6% poly-resistance 8.7% multidrug resistance). 17% patients developed further AIDS-defining illnesses. 67.2% died (median time to death 20 days). Three baseline variables were predictive of death by multivariate analysis: increased TBM grade [adjusted hazard ratio (AHR) 1.73, 95% CI 1.08-2.76, p = 0.02], lower serum sodium (AHR 0.93, 95% CI 0.89 to 0.98, p = 0.002) and decreased CSF lymphocyte percentage (AHR 0.98, 95% CI 0.97 to 0.99, p = 0.003).
Conclusions: HIV-associated TBM is devastating disease with a dismal prognosis. CSF findings included CSF neutrophil predominance, high rates of smear and culture positivity, and high rates of antituberculous drug resistance. Three baseline variables were independently associated with death: increased TBM grade; low serum sodium and decreased CSF lymphocyte percentage.
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust
المشرفين على المادة: 0 (Antitubercular Agents)
تواريخ الأحداث: Date Created: 20080320 Date Completed: 20080808 Latest Revision: 20220318
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC2262136
DOI: 10.1371/journal.pone.0001772
PMID: 18350135
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0001772