[Neuromeningeal tuberculosis in northeastern suburbs of Paris. Nineteen cases].
METHODS
Analyze characteristics of neuromeningeal tuberculosis in the northeastern suburbs of Paris.


METHODS
Retrospective study of 19 observations between 1988 and 1999.


RESULTS
Thirteen cases of meningitis, 3 cases of meningitis associated with a tuberculoma and 3 cases with isolated tuberculoma were described. Young subjects (average age 46.4), foreign born (73.7%) were preferentially affected. Three patients were infected by the human immunodeficiency virus. Weight-loss and weakness (84%), fever (79%), headache (63%) dominate the clinical manifestations. The diagnosis delay was 56.6 days, and the therapeutic time, 8.6 days. The search for acid fast bacilli was positive only in one case on direct examination of the cerebrospinal fluid, whereas the culture was positive in 68.7% of the cases. Cerebral imagery was abnormal in13 patients. Average duration of antituberculous treatment was 13,4 months (range: 9-24). Corticosteroids were associated in 12 patients. Thirteen patients were cured, 3 died and 3 were lost to follow up.


CONCLUSIONS
The characteristics of neuromeningeal tuberculosis are not modified, but the diagnosis delay of the neuromeningeal tuberculosis, which conditions the prognosis, remains significant. The optimal duration of the antituberculous treatment and the conditions of the steroid therapy have to be specified.
Grimaud-Ayina
Mylène
M
Service de Médecine Interne, Laboratoire de Microbiologie, Hôpital Jean-Verdier, 93143 Bondy Cedex, France.
Fain
Olivier
O
Lortholary
Olivier
O
Cruaud
Philippe
P
Kettaneh
Adrien
A
Stirnemann
Jérôme
J
Hornstein
Michèle
M
Robineau
Michel
M
Le Pennec
Marie-Pierre
MP
Boudon
Pierrette
P
Malbec
Denis
D
Mechali
Denis
D
Desrues
Jacques
J
Glowinski
Jacques
J
Guillevin
Loïc
L
Thomas
Michel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D018881:Suburban Health; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*