title: Tuberculous meningitis in infancy.
abstract: 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.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital, Niao Sung, Kaohsiung County, Taiwan.
authors.forename: Yu-Ren
authors.initials: YR
authors.lastname: Tung
authors.forename: Ming-Chi
authors.initials: MC
authors.lastname: Lai
authors.forename: Chun-Chung
authors.initials: CC
authors.lastname: Lui
authors.forename: Kun-Lin
authors.initials: KL
authors.lastname: Tsai
authors.forename: Li-Tung
authors.initials: LT
authors.lastname: Huang
authors.forename: Ying-Chao
authors.initials: YC
authors.lastname: Chang
authors.forename: Song-Chei
authors.initials: SC
authors.lastname: Huang
authors.forename: San Nan
authors.initials: SN
authors.lastname: Yang
authors.forename: Pi-Lien
authors.initials: PL
authors.lastname: Hung
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents