title: Tuberculous meningitis and miliary tuberculosis in young children.
abstract: OBJECTIVE
  To document the clinical and diagnostic features of tuberculous meningitis (TBM) in young children with and without concomitant miliary tuberculosis (TB).
  
  
  METHODS
  A retrospective comparative study.
  
  
  RESULTS
  Of 104 children with TBM, 32 (31%), median age 17.0 months, had a miliary appearance on chest radiograph; 72 (69%), median age 30.5 months, had TBM only (P = 0.04). Mediastinal adenopathy was noted in 27 (84%) of the children with miliary TB and 33 (46%) of those with TBM only (P = 0.0005). The mean cerebrospinal fluid (CSF) lymphocyte and polymorphonuclear counts of all children (no significant differences between groups) were 137 x 10(6)/l and 38 x 10(6)/l and the mean protein and glucose concentrations were 1.45 g/l and 0.72 mmol/l, respectively. Polymorphonuclear leukocytes were predominant in the CSF of 17% of children, in 16% the CSF glucose was > 2.2 mmol/l and in 26% the CSF protein was < 0.8 g/l. On Mantoux testing 37 (65%) of 57 children with TBM only and 12 (48%) of 25 children with TBM and miliary TB had an induration of > or = 10 mm (P = 0.23). Ten children (10%) died, five (7%) who had TBM only and five (16%) who had TBM and miliary TB.
  
  
  CONCLUSIONS
  Children with TBM and miliary TB were younger and more likely to have mediastinal adenopathy on chest radiography than those with TBM only. Diagnostic features and investigations in both groups may be misleading at times.
authors.affiliation: Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van den Bos
authors.forename: M
authors.initials: M
authors.lastname: Terken
authors.forename: L
authors.initials: L
authors.lastname: Ypma
authors.forename: J L L
authors.initials: JL
authors.lastname: Kimpen
authors.forename: E D
authors.initials: ED
authors.lastname: Nel
authors.forename: H S
authors.initials: HS
authors.lastname: Schaaf
authors.forename: J F
authors.initials: JF
authors.lastname: Schoeman
authors.forename: P R
authors.initials: PR
authors.lastname: Donald
mesh_terms: D017677:Age Distribution; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000150:complications* / Q000453:epidemiology; D014391:Tuberculosis, Miliary / Q000134:cerebrospinal fluid / Q000150:complications* / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents