title: Central nervous system and spinal tuberculosis in children at a tertiary care center in Saudi Arabia.
abstract: OBJECTIVE
  Tuberculosis (TB) remains a global health problem. There is limited data on pediatric central nervous system tuberculosis (CNSTB) in Saudi Arabia on diagnosis and therapy.
  
  
  METHODS
  Retrospective review of health record of pediatric patients < 14 years old who were diagnosed as having CNSTB or spinal TB and admitted to a tertiary care center.
  
  
  METHODS
  Health records and microbiology data of pediatric patients diagnosed with CNSTB were over 20-year period were reviewed. Data on demographics, clinical presentation, surgical interventions, neuroimaging, mycobacterial cultures and susceptibility and treatment were collected.
  
  
  RESULTS
  Thirteen children were diagnosed with CNSTB or spinal TB. Tuberculoma was the most frequent in 8 cases (62%), followed by TB of the spine in 4 cases (31%), and one case of meningitis. Six patients had a history of TB contact (46%) and 8 (62%) patients had a positive tuberculin skin test (TST). Seizure and weakness was the most frequent symptoms (38% each), while fever was less frequently encountered (23%). Tissue cultures (brain tissues/spinal tissues) showed a high yield (92%) of Mycobacterium tuberculosis with positive cultures for 11 surgical specimens out of 12 for whom cultures were done. There were no surgical complications from biopsies. All of MTB isolates were sensitive to first-line agents.
  
  
  CONCLUSIONS
  Brain or spinal biopsy is safe and has a high culture yield for MTB so it is advisable to perform a biopsy for any child in whom CNSTB is suspected and when there is no other less risky involved site for biopsy. All MTB isolates in this series were sensitive to first-line anti-tubercular agents.
authors: Najran University Hospital, College of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors: Mohammed
authors: M
authors: Al Ayed
authors: Suliman
authors: S
authors: Al Jumaah
authors: Essam
authors: E
authors: AlShail
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D062606:Tertiary Care Centers; D014374:Tuberculin Test; D020306:Tuberculosis, Central Nervous System / Q000175:diagnosis / Q000453:epidemiology*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis / Q000453:epidemiology*; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000453:epidemiology*