| Autor: |
Graham S Cooke, Hanif Esmail |
| Rok vydání: |
2021 |
| Předmět: |
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| Zdroj: |
Tuberculosis in Clinical Practice ISBN: 9783030755089 |
| DOI: |
10.1007/978-3-030-75509-6_6 |
| Popis: |
Tuberculosis (TB) affecting the central nervous system (CNS) accounts for 1% of presentations and can either manifest as a subacute lymphocytic meningitis or with neurological deficit relating to space-occupying tuberculoma. Of all the forms of TB it has the most unfavourable outcome especially when patients present with a reduced conscious level. Due to its paucibacillary nature CNS TB is difficult to diagnose though the recent development of Xpert MTB/RIF Ultra promises a rapid diagnostic with high sensitivity. It is important to ensure a large volume of CSF (8–10 mL) is taken to improve the likelihood of a microbiological diagnosis. For treatment, the CSF penetration of drugs is important to consider, however, the recommended first-line regimen for drug sensitive CNS disease is typically the same as for other forms of TB though for 12 rather than 6 months. Adjunctive therapy with Dexamethasone has been shown to reduce mortality and should be prescribed in a tapering dose along with anti-tuberculous therapy. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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