title: [Persistent neutrophilic meningitis in a patient with the acquired immunodeficiency syndrome].
abstract: Persistent neutrophilic meningitis is rarely found and it is characterized by predominance of the number of neutrophils in samples of C SF (cerebrospinal fluid) from the patient after seven days of treatment. The above patient in HIV positive; he has developed fever and mental disorder for 4 months and has presented neutrophilic pleocytosis in analysis of CSF for more than 5 months. Since the beginning or the treatment he has taken antituberculous drugs and corticosteroids. For 3 months, the serologic evaluation, smears and cultures were negative. On the 60th day in hospital, the investigation of acid-fast bacilli in CSF was positive and culture confirmed the presence of Mycobacterium tuberculosis resistant to isoniazid. Several factors that may have caused this uncommon development were discussed: the disturbance of cell-mediated immunity, mainly in release of IL 8 and TNF, the simultaneous use of medicines that could alter the CSF concentration of antituberculous drugs, and the increasing number of multiresistant strains.
authors.affiliation: Instituto de Infectologia Emilio Ribas, São Paulo, Brasil.
authors.forename: S F
authors.initials: SF
authors.lastname: Marinho
authors.forename: V H
authors.initials: VH
authors.lastname: Paciullo
authors.forename: M O
authors.initials: MO
authors.lastname: Fonseca
authors.forename: Z
authors.initials: Z
authors.lastname: Khoury
authors.forename: M A
authors.initials: MA
authors.lastname: Yamin
authors.forename: R
authors.initials: R
authors.lastname: Minkoves
authors.forename: M O
authors.initials: MO
authors.lastname: Andrade
authors.forename: M M
authors.initials: MM
authors.lastname: Cavallari
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000163:Acquired Immunodeficiency Syndrome / Q000134:cerebrospinal fluid / Q000150:complications*; D000328:Adult; D002555:Cerebrospinal Fluid / Q000166:cytology; D017809:Fatal Outcome; D015497:HIV-1; D006801:Humans; D008297:Male; D008581:Meningitis / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D009504:Neutrophils; D015819:Substance Abuse, Intravenous / Q000150:complications; D013997:Time Factors; D014390:Tuberculosis, Meningeal / Q000175:diagnosis