title: [Tuberculous meningitis: diagnosis and therapeutic difficulties].
abstract: Tuberculosis remains a public-health problem in 2010 with 9 millions cases and 1,7 million deaths worldwide each year. Tuberculosis meningitis is rare (0.5 to 1%) but is associated with high mortality and disability among survivors. An early starting of treatment is crucial. Despite molecular biology methods, microbiological diagnosis remains a challenge for the biologist. We report here 2 cases of tuberculous meningitis with different clinical and biological presentations, which underline diagnosis and therapeutic difficulties encountered in the management of this disease. The first one occurred in an HIV infected patient and the second one was caused by a multidrug-resistant strain. Clinical issues were severe with important neurological residual disability and death. Biological methods available for tuberculous meningitis diagnosis are exposed.
authors.affiliation: Service de Biologie Médicale, Hôpital d'Instruction des Armées Bégin, Saint Mandé, Ecole du Val-de-Grâce, Paris. janvierfred@hotmail.com
authors.forename: Frédéric
authors.initials: F
authors.lastname: Janvier
authors.forename: Audrey
authors.initials: A
authors.lastname: Mérens
authors.forename: Michel
authors.initials: M
authors.lastname: Fabre
authors.forename: Hervé
authors.initials: H
authors.lastname: Delacour
authors.forename: Christophe
authors.initials: C
authors.lastname: Pelletier
authors.forename: Charles
authors.initials: C
authors.lastname: Soler
authors.forename: Christophe
authors.initials: C
authors.lastname: Rapp
authors.forename: Jean-Didier
authors.initials: JD
authors.lastname: Cavallo
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000188:drug therapy*; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis
chemical_list: D000995:Antitubercular Agents