Multidrug-resistant tuberculous meningitis in patients with AIDS

George L. Daikos, T. Cleary, A. Rodriguez, M. A. Fischl

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

We present clinical manifestations, bacteriologic characteristics, and outcomes for eight patients with multi-drug-resistant (MDR) tuberculous meningitis and AIDS. All developed meningitis as a terminal complication of previously diagnosed MDR-TB despite anti-tuberculosis therapy. Seven patients presented with fever, five with headache, four with altered mentation, two with focal deficits and one with seizures. CSF examination revealed pleocytosis, hypoglychorrhachia and elevated protein. Mycobacterium tuberculosis resistant to at least isoniazid and rifampin was isolated from all patients. Intracerebral mass lesions were detected in three patients, hydrocephalus in three, meningeal enhancement in five, and infarcts in two. Seven patients died 1-16 weeks after the diagnosis of meningitis; the eighth was lost to follow-up. MDR tuberculous meningitis is a difficult-to-treat infection with a high fatality rate.

Original languageEnglish (US)
Pages (from-to)394-398
Number of pages5
JournalInternational Journal of Tuberculosis and Lung Disease
Volume7
Issue number4
StatePublished - Apr 1 2003

Keywords

  • HIV
  • Meningitis
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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