The diagnosis and medical management of tuberculous meningitis in adults

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dc.contributor.authorMarais, S
dc.contributor.authorWilkinson, R J
dc.date.accessioned2021-10-08T07:20:30Z
dc.date.available2021-10-08T07:20:30Z
dc.date.issued2014
dc.description.abstractTuberculous meningitis (TBM) is a medical emergency for which tuberculosis (TB) treatment should be initiated as soon as possible after diagnosis. Owing to the low diagnostic yields of confirmatory tests, TBM is often diagnosed based on suggestive clinical and cerebrospinal fluid findings, evidence for TB outside the central nervous system (CNS), typical brain imaging features and exclusion of other causes of meningitis. TB drug regimens used in TBM may be suboptimal as they are informed by studies of TB outside the CNS, rather than being based on randomised controlled trials in TBM. TBM has a high mortality and the management of HIV-co-infected patients is further complicated by neurological TB-immune reconstitution inflammatory syndrome (IRIS), which frequently occurs after starting antiretroviral therapy (ART) during TBM treatment and contributes to the poor outcome in HIV-associated TBM. HIV-infected TBM patients due to start ART should be counselled about the risk of developing neurological TB-IRIS, typical symptoms that could be expected and need to return to hospital should any of these develop. Currently, the only evidence-based treatment for TB-IRIS is with corticosteroids, which should be considered in all cases of neurological TB-IRIS.
dc.identifier.apacitationMarais, S., & Wilkinson, R. J. (2014). The diagnosis and medical management of tuberculous meningitis in adults. <i>South African Medical Journal</i>, 104(12), 895 - 177. http://hdl.handle.net/11427/34936en_ZA
dc.identifier.chicagocitationMarais, S, and R J Wilkinson "The diagnosis and medical management of tuberculous meningitis in adults." <i>South African Medical Journal</i> 104, 12. (2014): 895 - 177. http://hdl.handle.net/11427/34936en_ZA
dc.identifier.citationMarais, S. & Wilkinson, R.J. 2014. The diagnosis and medical management of tuberculous meningitis in adults. <i>South African Medical Journal.</i> 104(12):895 - 177. http://hdl.handle.net/11427/34936en_ZA
dc.identifier.issn0038-2469
dc.identifier.ris TY - Journal Article AU - Marais, S AU - Wilkinson, R J AB - Tuberculous meningitis (TBM) is a medical emergency for which tuberculosis (TB) treatment should be initiated as soon as possible after diagnosis. Owing to the low diagnostic yields of confirmatory tests, TBM is often diagnosed based on suggestive clinical and cerebrospinal fluid findings, evidence for TB outside the central nervous system (CNS), typical brain imaging features and exclusion of other causes of meningitis. TB drug regimens used in TBM may be suboptimal as they are informed by studies of TB outside the CNS, rather than being based on randomised controlled trials in TBM. TBM has a high mortality and the management of HIV-co-infected patients is further complicated by neurological TB-immune reconstitution inflammatory syndrome (IRIS), which frequently occurs after starting antiretroviral therapy (ART) during TBM treatment and contributes to the poor outcome in HIV-associated TBM. HIV-infected TBM patients due to start ART should be counselled about the risk of developing neurological TB-IRIS, typical symptoms that could be expected and need to return to hospital should any of these develop. Currently, the only evidence-based treatment for TB-IRIS is with corticosteroids, which should be considered in all cases of neurological TB-IRIS. DA - 2014 DB - OpenUCT DP - University of Cape Town IS - 12 J1 - South African Medical Journal LK - https://open.uct.ac.za PY - 2014 SM - 0038-2469 T1 - The diagnosis and medical management of tuberculous meningitis in adults TI - The diagnosis and medical management of tuberculous meningitis in adults UR - http://hdl.handle.net/11427/34936 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34936
dc.identifier.vancouvercitationMarais S, Wilkinson RJ. The diagnosis and medical management of tuberculous meningitis in adults. South African Medical Journal. 2014;104(12):895 - 177. http://hdl.handle.net/11427/34936.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceSouth African Medical Journal
dc.source.journalissue12
dc.source.journalvolume104
dc.source.pagination895 - 177
dc.source.urihttps://dx.doi.org/10.7196/SAMJ.9060
dc.subject.otherTuberculous meningitis
dc.subject.otherAdults
dc.titleThe diagnosis and medical management of tuberculous meningitis in adults
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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