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Central nervous system and spinal tuberculosis in children at a tertiary care center in Saudi Arabia

Mohammed Al Ayed1, Suliman Al Jumaah, Essam AlShail

  • 1Najran University Hospital, College of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

Annals of Saudi Medicine
|March 6, 2013
PubMed

Insights

Pediatric central nervous system tuberculosis (CNSTB) diagnosis in Saudi Arabia is challenging. Brain or spinal biopsy offers a safe and high-yield method for identifying Mycobacterium tuberculosis (MTB) in suspected cases.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Tuberculosis (TB) remains a significant global health challenge.
  • Limited data exists on pediatric central nervous system tuberculosis (CNSTB) diagnosis and treatment in Saudi Arabia.

Purpose of the Study:

  • To review diagnostic and therapeutic approaches for pediatric CNSTB in Saudi Arabia.
  • To evaluate the safety and efficacy of surgical biopsies in diagnosing CNSTB.

Main Methods:

  • Retrospective review of health records for pediatric patients (<14 years) diagnosed with CNSTB or spinal TB over 20 years.
  • Collected data included demographics, clinical presentation, surgical interventions, neuroimaging, mycobacterial cultures, susceptibility, and treatment.
  • Analyzed microbiology data from surgical specimens.

Main Results:

  • Thirteen pediatric cases of CNSTB or spinal TB were identified.
  • Tuberculoma was the most common diagnosis (62%), followed by spinal TB (31%).
  • Surgical biopsies yielded Mycobacterium tuberculosis (MTB) in 92% of cases, with no complications. All isolates were sensitive to first-line anti-TB drugs.

Conclusions:

  • Brain or spinal biopsy is a safe procedure with a high diagnostic yield for MTB in suspected pediatric CNSTB.
  • Biopsy is recommended for children with suspected CNSTB when less invasive methods are inconclusive.
  • All identified MTB strains were susceptible to standard first-line anti-tubercular agents.
Abstract

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