Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study.
Background: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there m...
| Publicado en: | BMC Infectious Diseases Vol. 16; pp. 1 - 9 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
6/16/2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116286308&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116286308 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712334 1CHU jtl: BMC Infectious Diseases issn: 14712334 maglogo: N pubinfo: dt: 6/16/2016 vid: 16 pid: 24147 pub: BioMed Central artinfo: ui: 116286308 116286308 NLM27306100 116286308 10.1186/s12879-016-1640-x NLM27306100 PMC4910197 116286308 ppf: 1 ppct: 8 formats: tig: atl: Tuberculous meningitis is a major cause of mortality and morbidity in adults with central nervous system infections in Kota Kinabalu, Sabah, Malaysia: an observational study. aug: au: Heng Gee Lee William, Timothy Menon, Jayaram Ralph, Anna P. Eng Eong Ooi Yan'an Hou Sessions, October Tsin Wen Yeo Lee, Heng Gee Ooi, Eng Eong Hou, Yan'an Yeo, Tsin Wen affil: Department of Medicine, The Infectious Disease Unit, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia sug: subj: Tuberculosis, Meningeal Epidemiology Meningoencephalitis Epidemiology Meningitis, Cryptococcal Epidemiology Adult Mycobacterium Tuberculosis Polymerase Chain Reaction Aged Culture Techniques Prospective Studies Central Nervous System Infections Mortality Meningoencephalitis Cerebrospinal Fluid Meningitis, Cryptococcal Mortality Meningitis, Cryptococcal Microbiology Middle Age Central Nervous System Infections Cerebrospinal Fluid Meningoencephalitis Mortality Central Nervous System Infections Epidemiology Cryptococcus Adolescence Tuberculosis, Meningeal Cerebrospinal Fluid Malaysia Tuberculosis, Meningeal Mortality Male Meningoencephalitis Microbiology Female Meningitis, Cryptococcal Cerebrospinal Fluid Tuberculosis, Meningeal Microbiology Central Nervous System Infections Microbiology Young Adult Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Adolescent: 13-18 years Male Female ab: Background: Central nervous system (CNS) infections are a significant contributor to morbidity and mortality globally. However, most published studies have been conducted in developed countries where the epidemiology and aetiology differ significantly from less developed areas. Additionally, there may be regional differences due to variation in the socio-economic levels, public health services and vaccination policies. Currently, no prospective studies have been conducted in Sabah, East Malaysia to define the epidemiology and aetiology of CNS infections. A better understanding of these is essential for the development of local guidelines for diagnosis and management.Methods: We conducted a prospective observational cohort study in patients aged 12 years and older with suspected central nervous system infections at Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia between February 2012 and March 2013. Cerebrospinal fluid was sent for microscopy, biochemistry, bacterial and mycobacterial cultures, Mycobacterium tuberculosis polymerase chain reaction (PCR), and multiplex and MassCode PCR for various viral and bacterial pathogens.Results: A total of 84 patients with clinically suspected meningitis and encephalitis were enrolled. An aetiological agent was confirmed in 37/84 (44 %) of the patients. The most common diagnoses were tuberculous meningitis (TBM) (41/84, 48.8 %) and cryptococcal meningoencephalitis (14/84, 16.6 %). Mycobacterium tuberculosis was confirmed in 13/41 (31.7 %) clinically diagnosed TBM patients by cerebrospinal fluid PCR or culture. The acute case fatality rate during hospital admission was 16/84 (19 %) in all patients, 4/43 (9 %) in non-TBM, and 12/41 (29 %) in TBM patients respectively (p = 0.02).Conclusion: TBM is the most common cause of CNS infection in patients aged 12 years or older in Kota Kinabalu, Sabah, Malaysia and is associated with high mortality and morbidity. Further studies are required to improve the management and outcome of TBM. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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