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Mortality associated with central nervous system tuberculosis.

Hana M El Sahly1, Larry D Teeter, Xi Pan

  • 1Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.

The Journal of Infection
|October 9, 2007
PubMed
Summary
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Central nervous system tuberculosis (CNSTB) has high mortality. Hydrocephalus emerged as the strongest predictor of death in CNSTB patients, highlighting its critical role in prognosis for this severe form of tuberculosis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Central nervous system tuberculosis (CNSTB) presents higher mortality rates compared to other tuberculosis forms.
  • Limited large-scale population-based studies in the US have assessed epidemiological associations and prognostic indicators for CNSTB.

Purpose of the Study:

  • To investigate sociodemographic, clinical, and Mycobacterium tuberculosis genotype variables in CNSTB patients.
  • To identify risk factors associated with mortality in CNSTB patients within a large US population.

Main Methods:

  • A population-based active surveillance study was conducted between 1995 and 2004.
  • Patients with CNSTB were compared to those with non-central nervous system tuberculosis (non-CNSTB).
  • Cox proportional hazard models were used to analyze mortality risk factors at 180 days.

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Main Results:

  • The study included 92 CNSTB cases and 3570 non-CNSTB cases.
  • HIV co-infection was present in 33.7% of CNSTB cases.
  • Older age, positive CNS Mycobacterium tuberculosis culture, and hydrocephalus were significant predictors of 180-day mortality in CNSTB patients.

Conclusions:

  • Hydrocephalus was identified as the most significant predictor of mortality following CNSTB diagnosis.
  • These findings underscore the importance of managing hydrocephalus in improving outcomes for CNSTB patients.