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Central system nervous tuberculosis in infants

Faten Tinsa1, Leila Essaddam, Zohra Fitouri

  • 1Department of Pediatrics B, Children's Hospital of Tunis, Tunis, Tunisia. faten.tinsa@hotmail.fr

Journal of Child Neurology
|December 25, 2009
PubMed

Insights

Diagnosing tuberculous meningitis in infants is challenging due to non-specific symptoms. Despite diagnostic delays, most infants showed improved cerebrospinal fluid findings and few severe outcomes after treatment.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Tuberculous meningitis (TBM) presents with nonspecific symptoms, complicating early diagnosis in infants.
  • Infants with central nervous system tuberculosis require careful clinical evaluation and management.

Purpose of the Study:

  • To review the clinical features and laboratory findings of infants diagnosed with central nervous system tuberculosis.
  • To analyze diagnostic delays and patient outcomes in a cohort of infants with TBM.

Main Methods:

  • Retrospective review of clinical data from 6 infants diagnosed with central nervous system tuberculosis over a 10-year period.
  • Analysis of cerebrospinal fluid (CSF) profiles, neuroimaging (CT/MRI), and treatment outcomes.

Main Results:

  • The mean time to diagnosis was 32 days, with only 2 cases identifying a contact source.
  • All infants exhibited abnormal CSF findings (lymphocytic pleocytosis <500 cells/µL).
  • Hydrocephalus and basal enhancement were noted in 2 patients; rare tuberculomas causing compression and diabetes insipidus occurred in one patient post-treatment.

Conclusions:

  • Early diagnosis of TBM in infants remains difficult due to subtle clinical presentations.
  • Despite diagnostic delays, prompt antituberculous treatment can lead to favorable outcomes, with most patients experiencing hearing improvement and minimal severe sequelae.

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