Prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis.
OBJECTIVE
To identify prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis based on clinical, epidemiological, and laboratory findings.


METHODS
The clinical records of all in-patients diagnosed with neurotuberculosis from 1982 to 2005 were evaluated retrospectively. The following prognostic parameters were examined: gender, age, close contact with a tuberculosis-infected individual, vaccination for bacillus Calmette-Guérin, purified protein derivative (PPD) of tuberculin results, concomitant miliary tuberculosis, seizures, CSF results, and hydrocephalus.


RESULTS
One hundred forty-one patients diagnosed with neurotuberculosis were included. Seventeen percent of the cases resulted in death. The factors that were correlated with a negative outcome included lack of contact with a tuberculosis-infected individual, negative PPD reaction, coma, and longer hospitalisation time. A multiple logistic regression analysis was performed to identify which of these factors most often resulted in death.


CONCLUSIONS
Coma at diagnosis, lack of tuberculosis contact, and a non-reactive PPD were the most important predictors of fatality in patients with neurotuberculosis.
Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, SP, Brazil. mgimenes@npd.ufes.br
Murilo Gimenes
MG
Rodrigues
Jaime
J
Lin
Marcelo Rodrigues
MR
Masruha
Luiz Celso Pereira
LC
Vilanova
Thais Soares Cianciarullo
TS
Minett
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020306:Tuberculosis, Central Nervous System / Q000175:diagnosis / Q000401:mortality*