Tuberculous meningitis in infancy.
The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. To our knowledge, there has been no report in the literature focusing on tuberculous meningitis patients younger than 1 year of age. In this report, we reviewed the clinical features and laboratory findings of seven infants with tuberculous meningitis encountered during a 15-year period. All patients had fever, cough, and alternation of consciousness at presentation. Five patients had bulging anterior fontanel, and five had generalized tonic-clonic seizures. The purified protein derivative skin test was positive in six patients. Six patients had hyponatremia. All seven patients had abnormal cerebrospinal fluid findings, and six of them demonstrated cell counts less than 500 cells/mm(3) with lymphocytic predominance. Brain sonography examination revealed hydrocephalus in all seven patients. Therefore we conclude that antituberculosis therapy should be promptly initiated in any young infant with a clinical impression of meningitis in the context of cerebrospinal fluid white cell count of less than 500 cells/mm(3) and lymphocytic predominance, hyponatremia, and hydrocephalus.
Tung
Yu-Ren
YR
Department of Pediatrics, Chang Gung Memorial Hospital, Niao Sung, Kaohsiung County, Taiwan.
Lai
Ming-Chi
MC
Lui
Chun-Chung
CC
Tsai
Kun-Lin
KL
Huang
Li-Tung
LT
Chang
Ying-Chao
YC
Huang
Song-Chei
SC
Yang
San Nan
SN
Hung
Pi-Lien
PL
D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011859:Radiography; D013624:Taiwan / Q000453:epidemiology; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology
D000995:Antitubercular Agents