Central system nervous tuberculosis in infants.
The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. In this report, we reviewed the clinical features and laboratory findings of 6 infants with central system nervous tuberculosis during a 10-year period. One of the patients had multifocal tuberculosis. The mean time to the diagnosis was 32 +/- 13.4 days. A contact source was identified in only 2 patients. All 6 patients had abnormal cerebrospinal fluid findings, less than 500 cells/microL with lymphocytic predominance. Computerized tomography (CT) and/or magnetic resonance imaging (MRI) revealed hydrocephalus with basal enhancement in 2 patients. One patient developed pontocerebellar and pituitary tuberculomas, which were responsible for compression and diabetes insipidus, 1 year after antituberculous treatment. These localizations are very rare. On the follow-up, 3 patients had hypoacousia and only 1 had severe sequelae, despite a diagnostic delay.
Tinsa
Faten
F
Department of Pediatrics B, Children's Hospital of Tunis, Tunis, Tunisia. faten.tinsa@hotmail.fr
Essaddam
Leila
L
Fitouri
Zohra
Z
Boussetta
Khadija
K
Ben Becher
Saida
S
Bousnina
Souad
S
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002526:Cerebellar Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology; D002675:Child, Preschool; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D010900:Pituitary Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology; D011149:Pons / Q000000981:diagnostic imaging / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000473:pathology; D020306:Tuberculosis, Central Nervous System / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000473:pathology