title: [Tuberculous meningitis in childhood: review of cases observed in the years 1995-1999].
abstract: In this study we reviewed M. tuberculosis meningitis (TBM) cases in childhood at our unit in a five-year period.
  
  
  METHODS
  Included in this retrospective study were children admitted to Cotugno Hospital from 1995 to 1999 who fulfilled criteria for a TBM diagnosis. Medical records were analyzed for epidemiological data, clinical manifestations, laboratory test results, radiological investigations and clinical outcome.
  
  
  RESULTS
  We identified 10 children with TBM. Family history of tuberculosis (TB) was observed in 6 patients. Fever preceded hospital admission of 4-60 days (median 8 days); neurological signs were present 1-6 days before admission in 8 patients. All patients showed a predominance of lymphocytes, elevated proteins and reduced glucose concentration in cerebrospinal fluid (CSF). Mycobacterium tuberculosis was either cultured or identified by acid fast stain in 5 patients. Cranial CT-scans and MRI showed hydrocephalus in 8 patients and ring-enhancing lesions in 6. Antituberculous therapy was administered according to current recommendations for at least 12 months, with a 4-6 week steroid therapy course. Two patients had permanent neurological sequelae.
  
  
  CONCLUSIONS
  Careful evaluation of symptoms and CSF findings is the only way to establish an early diagnosis and reduce sequelae.
authors.affiliation: Centro Neuropatie Infettive, Ospedale D. Cotugno - Napoli, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pagliano
authors.forename: U
authors.initials: U
authors.lastname: Fusco
authors.forename: V
authors.initials: V
authors.lastname: Attanasio
authors.forename: M
authors.initials: M
authors.lastname: Conte
authors.forename: N
authors.initials: N
authors.lastname: Maturo
authors.forename: A
authors.initials: A
authors.lastname: Prejano
authors.forename: C
authors.initials: C
authors.lastname: Rescigno
authors.forename: F S
authors.initials: FS
authors.lastname: Faella
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology