Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/630
Type: Artigo de periódico
Title: Tuberculous meningitis in HIV-infected patients in Brazil: clinical and laboratory characteristics and factors associated with mortality
Author: CRODA, Mariana G.
VIDAL, Jose E.
HERNANDEZ, Adrian V.
MOLIN, Tiago Dal
GUALBERTO, Felipe A.
OLIVEIRA, Augusto C. Penalva de
Abstract: Background: Tuberculous meningitis (TBM) is a growing problem in HIV-infected patients in developing countries, where there is scarce data about this co-infection. Our objectives were to analyze the main features and outcomes of HIV-infected patients with TBM. Methods: This was a retrospective study of HIV-infected Brazilian patients admitted consecutively for TBM. All patients had Mycobacterium tuberculosis isolated from the cerebrospinal fluid (CSF). Presenting clinical and laboratory features were studied. Multivariate analysis was used to identify variables associated with death during hospitalization and at 9 months after diagnosis. Survival was estimated using the Kaplan-Meier method. Results: We included 108 cases (median age 36 years, 72% male). Only 15% had fever, headache, and meningeal signs simultaneously. Forty-eight percent had extrameningeal tuberculosis. The median CD4+ cell count was 65 cells/mu l. Among 90 cases, 7% had primary resistance to isoniazid and 9% presented multidrug-resistant strains. The overall mortality during hospitalization was 29% and at 9 months was 41%. Tachycardia and prior highly active antiretroviral therapy (HAART) were associated with 9-month mortality. The 9-month survival rate was 22% (95% confidence interval 12-43%). Conclusions: Clinical and laboratory manifestations were unspecific. Disseminated tuberculosis and severe immunosuppression were common. Mortality was high and the 9-month survival rate was low. Tachycardia and prior HAART were associated with death within 9 months of diagnosis. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Subject: Tuberculous meningitis
Diagnosis
Central nervous system
Tuberculosis
Acquired immunodeficiency syndrome
Brazil
Country: Inglaterra
Editor: ELSEVIER SCI LTD
Citation: INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, v.14, n.7, p.E586-E591, 2010
Rights: fechado
Identifier DOI: 10.1016/j.ijid.2009.08.012
Address: http://apps.isiknowledge.com/InboundService.do?Func=Frame&product=WOS&action=retrieve&SrcApp=EndNote&UT=000278650400007&Init=Yes&SrcAuth=ResearchSoft&mode=FullRecord
http://dx.doi.org/10.1016/j.ijid.2009.08.012
Date Issue: 2010
Appears in Collections:HC - Artigos e Outros Documentos

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