Multidrug-resistant tuberculous meningitis in KwaZulu-Natal, South Africa.
Multidrug-resistant (MDR) pulmonary tuberculosis (TB) is well described in the literature. Reports of MDR TB meningitis (MDR-TBM), however, are limited to case reports and a single case series. During the period of 1999-2002, 350 patients with TBM were identified by cerebrospinal fluid culture for TB. Thirty patients (8.6%) had TB that was resistant to at least isoniazid and rifampicin. All 30 patients were included in this study. We reviewed hospital charts of the patients with MDR-TBM and describe our experience. Seventeen patients with MDR-TBM died, and, of those who were known to be alive, many experienced significant morbidity. Eighteen patients were HIV positive. Twenty-two patients had been treated for TB in the past, 3 patients had received no previous treatment for TB, and the history of TB treatment was unknown for 5 patients. The study highlights the prevalence of MDR-TBM and identifies new challenges in the management of affected patients.
Department of Neurology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
V B
VB
Patel
N
N
Padayatchi
A I
AI
Bhigjee
J
J
Allen
B
B
Bhagwan
A A
AA
Moodley
T
T
Mthiyane
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D002648:Child; D024901:Drug Resistance, Multiple, Bacterial / Q000502:physiology*; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D012293:Rifampin / Q000494:pharmacology; D014390:Tuberculosis, Meningeal / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin