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Central nervous system tuberculosis in children.

R G Curless1, C D Mitchell

  • 1Department of Neurology, University of Miami School of Medicine, FL 33101.

Pediatric Neurology
|July 1, 1991
PubMed
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Childhood central nervous system tuberculosis is rising in the US. Early diagnosis using cranial computed tomography and cerebrospinal fluid analysis is crucial for prompt antituberculous therapy.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Tuberculosis incidence is increasing across all age groups in the United States.
  • Central nervous system (CNS) involvement occurs in 5% of all tuberculosis patients.
  • Childhood CNS tuberculosis is a rare but serious condition, often leading to delayed diagnosis due to low awareness.

Observation:

  • A study reviewed childhood CNS tuberculosis cases between 1979 and 1989, including literature review for patients up to 14 years of age.
  • Delayed diagnosis is a significant challenge due to the infrequent reporting of such cases in the US.
  • Cranial computed tomography (CT) within one week of symptom onset can identify key indicators.

Findings:

  • Radiographic findings on cranial CT may include basilar enhancement, hydrocephalus, or infarction.

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  • Cerebrospinal fluid (CSF) analysis reveals findings atypical for common bacterial infections.
  • Combined CT and CSF findings support the early initiation of antituberculous therapy.

    • Implications:

    • Prompt diagnosis and treatment are vital to improve outcomes for children with CNS tuberculosis.
    • Increased awareness among healthcare providers is necessary to reduce diagnostic delays.
    • Antituberculous therapy, guided by early diagnostic indicators, is essential for managing this condition.