Khemiri Monia, Bagais Abderrahmen, Becher Saayda Ben, Bousnina Souad, Bayoudh Fethi, Mehrezi Ahmed, Lakhoua Rachid, Barsaoui Siham
Pediatric A Department, Children's Hospital of Tunis, University of Tunis Elmanar, Tunisia.
J Child Neurol. 2012 Jun;27(6):741-6. doi: 10.1177/0883073811426930. Epub 2011 Dec 21.
The Bacille Calmette-Guérin vaccination (BCG) contributed widely to reduce tuberculosis incidence in developing countries. The aim of this report was to assess the clinical "spectrum" and outcome of tuberculous meningitis in 16 Bacille Calmette-Guérin-vaccinated Tunisian children. They were 9 boys and 7 girls aged 2 to 168 months (median 72 months ± 65.88). Patients presented mainly with nonspecific symptoms. Neurologic severity was classified as grade I (n = 6) and grade II or III (n = 10). At short-term course, the majority of patients developed serious complications: hydrocephalus (n = 12), seizures (n = 8), tuberculoma (n = 6), and acute respiratory failure (n = 2). Three patients died. Among survivors, 4 patients showed a complete recovery while 9 developed permanent sequelae which were mild (n = 6) to severe (n = 3). Despite the Bacille Calmette-Guérin vaccination, tuberculous meningitis remains a life-threatening condition; vaccinated children have shown common presentation of tuberculous meningitis in terms of severity and poor outcome.
卡介苗接种对降低发展中国家的结核病发病率起到了广泛作用。本报告的目的是评估16名接种过卡介苗的突尼斯儿童结核性脑膜炎的临床“谱”及转归。他们中有9名男孩和7名女孩，年龄在2至168个月之间（中位数为72个月±65.88）。患者主要表现为非特异性症状。神经功能严重程度分为I级（n = 6）和II级或III级（n = 10）。在短期病程中，大多数患者出现了严重并发症：脑积水（n = 12）、癫痫发作（n = 8）、结核瘤（n = 6）和急性呼吸衰竭（n = 2）。3名患者死亡。在幸存者中，4名患者完全康复，而9名患者出现了永久性后遗症，从轻度（n = 6）到重度（n = 3）不等。尽管接种了卡介苗，但结核性脑膜炎仍然是一种危及生命的疾病；接种疫苗的儿童在结核性脑膜炎的严重程度和不良转归方面表现出常见的症状。
