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婴儿中枢神经系统结核

Central system nervous tuberculosis in infants.

作者信息

Tinsa Faten, Essaddam Leila, Fitouri Zohra, Boussetta Khadija, Ben Becher Saida, Bousnina Souad

机构信息

Department of Pediatrics B, Children's Hospital of Tunis, Tunis, Tunisia.

出版信息

J Child Neurol. 2010 Jan;25(1):102-6. doi: 10.1177/0883073809336129.

Abstract

The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. In this report, we reviewed the clinical features and laboratory findings of 6 infants with central system nervous tuberculosis during a 10-year period. One of the patients had multifocal tuberculosis. The mean time to the diagnosis was 32 +/- 13.4 days. A contact source was identified in only 2 patients. All 6 patients had abnormal cerebrospinal fluid findings, less than 500 cells/microL with lymphocytic predominance. Computerized tomography (CT) and/or magnetic resonance imaging (MRI) revealed hydrocephalus with basal enhancement in 2 patients. One patient developed pontocerebellar and pituitary tuberculomas, which were responsible for compression and diabetes insipidus, 1 year after antituberculous treatment. These localizations are very rare. On the follow-up, 3 patients had hypoacousia and only 1 had severe sequelae, despite a diagnostic delay.

摘要

结核性脑膜炎患者缺乏特异性症状和体征,导致早期诊断困难。在本报告中,我们回顾了10年间6例中枢神经系统结核婴儿的临床特征和实验室检查结果。其中1例患者有多灶性结核。诊断的平均时间为32±13.4天。仅2例患者确定了接触源。所有6例患者脑脊液检查均异常,细胞数少于500个/微升,以淋巴细胞为主。计算机断层扫描(CT)和/或磁共振成像(MRI)显示2例患者有脑积水伴基底节强化。1例患者在抗结核治疗1年后出现桥小脑和垂体结核瘤,导致压迫和尿崩症。这些定位非常罕见。随访时,3例患者有听力减退,尽管诊断延迟,但只有1例有严重后遗症。

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