Bartzatt Ronald
University of Nebraska, College of Arts & Sciences, Durham Science Center, 6001 Dodge Street, Omaha, Nebraska 68182, USA.
Cent Nerv Syst Agents Med Chem. 2011 Dec 1;11(4):321-7. doi: 10.2174/1871524911106040321.
The causative agent of Tuberculosis meningitis is Mycobacterium tuberculosis, which is the bacteria that causes pulmonary tuberculosis. Proliferating into the central nervous system occurs from other sites of infection within the body. Brain damage can result from the infection that may lead to abnormal behavior, mental impairments, motor type paralysis, and seizures. Tuberculosis infections of the central nervous system are a serious and often fatal disease predominantly impacting young children, and is thought to be the most devastating form of the disease. Isoniazid is the only first line bactericidal agent that easily crosses the blood-brain barrier and achieves concentrations in cerebrospinal fluid similar to those in serum. Rifampicin, ethambutol, and streptomycin all penetrate into the cerebrospinal fluid poorly, and even in the setting of meningeal inflammation. As much as one-third of the current world's population may be infected with tuberculosis. Tuberculosis infection of the central nervous system is a serious type of extrapulmonary proliferation of this disease . In developing countries, it has high predominance in children. Pathological manifestations of cerebral tuberculosis occur, of which the most common is tuberculous meningitis, followed by tuberculoma, tuberculous abscess, cerebral miliary tuberculosis, tuberculous encephalopathy, tuberculous encephalitis, and tuberculous arteritis. Brain abscesses of Mycobacterium tuberculosis can induce seizures and coma leading to death and complicated due to multiorgan failure. Rapid diagnosis and early intervention is vital for successful outcome for patients. Further studies are required to understand the proliferation of tuberculosis meningitis in addition to the elucidation of new therapeutic drugs for the successful clinical treatment of this deadly disease.
结核性脑膜炎的病原体是结核分枝杆菌,它也是导致肺结核的细菌。结核菌从身体其他感染部位扩散至中枢神经系统。感染可导致脑损伤,进而引发行为异常、智力障碍、运动型瘫痪和癫痫发作。中枢神经系统结核感染是一种严重且往往致命的疾病,主要影响幼儿,被认为是该疾病最具毁灭性的形式。异烟肼是唯一一种能轻易穿过血脑屏障并在脑脊液中达到与血清中相似浓度的一线杀菌剂。利福平、乙胺丁醇和链霉素即使在脑膜有炎症的情况下,也很难渗透到脑脊液中。目前全球多达三分之一的人口可能感染了结核病。中枢神经系统结核感染是这种疾病严重的肺外扩散类型。在发展中国家,它在儿童中具有很高的发病率。脑部结核会出现多种病理表现,其中最常见的是结核性脑膜炎,其次是结核瘤、结核脓肿、脑粟粒性结核、结核性脑病、结核性脑炎和结核性动脉炎。结核分枝杆菌引起的脑脓肿可诱发癫痫发作和昏迷,导致死亡,并因多器官衰竭而病情复杂。快速诊断和早期干预对患者的成功治疗至关重要。除了阐明用于成功临床治疗这种致命疾病的新治疗药物外,还需要进一步研究来了解结核性脑膜炎的扩散情况。