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Tuberculous meningitis and miliary tuberculosis in young children
F van den Bos1, M Terken, L Ypma
1Utrecht University Medical Center, Utrecht, The Netherlands.
Tropical Medicine & International Health : TM & IH
|March 26, 2004
Summary
Tuberculous meningitis (TBM) in children with miliary TB were younger and showed more mediastinal adenopathy. Diagnostic features can be misleading in both TBM groups.
Area of Science:
- Pediatrics
- Infectious Diseases
- Radiology
Background:
- Tuberculous meningitis (TBM) is a severe infection in children.
- Distinguishing TBM with and without miliary tuberculosis (TB) is crucial for diagnosis and management.
- Clinical and diagnostic features can vary, impacting early identification.
Purpose of the Study:
- To document and compare the clinical and diagnostic features of TBM in young children.
- To investigate differences between TBM with concomitant miliary TB and TBM alone.
Main Methods:
- Retrospective comparative study design.
- Analysis of clinical data, chest radiography, cerebrospinal fluid (CSF) analysis, and Mantoux testing.
- Comparison of features between children with TBM and miliary TB versus TBM only.
Main Results:
- Children with TBM and miliary TB (31%) were younger (median 17.0 months) than those with TBM only (69%, median 30.5 months).
- Mediastinal adenopathy on chest radiography was more common in TBM with miliary TB (84%) compared to TBM only (46%).
- Cerebrospinal fluid (CSF) findings and Mantoux test results showed no significant differences between the groups, with some atypical results observed.
Conclusions:
- Younger age and mediastinal adenopathy are key indicators differentiating TBM with miliary TB from TBM alone.
- Diagnostic features and investigations for TBM can be challenging and sometimes misleading in both presentations.