Encephalitis due to Mycobacterium tuberculosis in France.
Details
Serval ID
serval:BIB_88E1E2A8B2D1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Encephalitis due to Mycobacterium tuberculosis in France.
Journal
Medecine et maladies infectieuses
Working group(s)
le comité de pilotage et groupe des investigateurs
Contributor(s)
Bébéar C., Brouard C., De Broucker T., Cua E., Dabernat H., Floret D., Guery B., Lecuit M., Lina B., Lortholary O., Mailles A., Michelet C., Morand P., Pozzetto B., Stahl J.P., Vaillant V., Zeller H., Abboud P., Alloui C., Archimbaud C., Barroso B., Bernard L., Beuret P., Billaud G., Boutolleau D., Bruneel F., Buisson M., Caramella A., Castan B., Cattaneo I., Cazanave C., Chabrier S., Chadenat M.L., Chambon M., Chavanet P., Clavelou P., Cua E., de Brabant F., De La Blanchardière A., De La Gastine G., De Montclos H., Denes E., Dewilde A., Dinh A., Emeriaud G., Epaulard O., Favaretto G., Fourrier F., Gaday V., Gaillat J., Gallet S., Gazuy N., Gouarin S., Gozlan J., Granier P., Gueit I., Guihot A., Guillet C., Guimard Y., Hansmann Y., Henquell C., Herrmann J., Honnorat J., Houhou N., Jaulhac B., Kossorotoff M., Laurent F., Laurichesse J.J., Lavoue S., Lazaro L., Legriel S., Lesens O., Mace M., Makinson A., Marchandin H., Martinez-Almoyna L., Marthelet P., Martinot M., Maulin L., Misset B., Neuwirth C., Nicot F., Pacanowski J., Palcoux J.B., Pavese P., Perpoint T., Pestel-Caron M., Pouyau R., Prendki V., Rapp C., Regagnon C., Rigal M., Roch N., Rogeaux O., Rogez S., Signori-Schmuck A., Simon F., Taimi A., Tayoro J., Terral D., Tourdjman M., Vuillemet F.
ISSN
1769-6690 (Electronic)
ISSN-L
0399-077X
Publication state
Published
Issued date
06/2013
Peer-reviewed
Oui
Volume
43
Number
6
Pages
230-238
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Two hundred and fifty-three patients were included in a study on the etiology of encephalitis, carried out in France in 2007. Tuberculosis was the second most frequently identified cause, after HSV and with the same number of cases as VZV. The authors report the specific features of patients presenting with tuberculosis encephalitis (TE).
TE patients were defined as patients presenting with encephalitis, with positive culture or PCR for Mycobacterium tuberculosis, or the association of clinical, biological, imaging, and epidemiological evidence (possible cases). Clinical, microbiological, and brain imaging data was analyzed and compared to that of other included patients.
Twenty cases of TE were identified. The M/F sex-ratio was 1.5, the mean age 53 years. Four (20%) patients had a history of tuberculosis before the encephalitis. The median delay between the onset of general and neurological symptoms was significantly longer for tuberculosis cases than for others (10 days vs. 2; P<10(-10)). The median CSF protein level was significantly higher for tuberculosis cases (2.1 g/L vs. 0.8 g/L, P=0.002). CT scan and MRI were normal on admission for eight patients out of 17. Fourteen isolated strains of M. tuberculosis were susceptible to first-line anti-tuberculosis drugs and one was rifampicin-resistant. Six (33%) patients died during hospitalization and two were lost to follow-up. Ten out of 12 (78.6%) had persisting neurological symptoms on discharge.
Despite non-multiresistant MT strains, the case fatality rate among TE patients was high in our series. Early brain imaging is poor contributive for the diagnosis of TE.
TE patients were defined as patients presenting with encephalitis, with positive culture or PCR for Mycobacterium tuberculosis, or the association of clinical, biological, imaging, and epidemiological evidence (possible cases). Clinical, microbiological, and brain imaging data was analyzed and compared to that of other included patients.
Twenty cases of TE were identified. The M/F sex-ratio was 1.5, the mean age 53 years. Four (20%) patients had a history of tuberculosis before the encephalitis. The median delay between the onset of general and neurological symptoms was significantly longer for tuberculosis cases than for others (10 days vs. 2; P<10(-10)). The median CSF protein level was significantly higher for tuberculosis cases (2.1 g/L vs. 0.8 g/L, P=0.002). CT scan and MRI were normal on admission for eight patients out of 17. Fourteen isolated strains of M. tuberculosis were susceptible to first-line anti-tuberculosis drugs and one was rifampicin-resistant. Six (33%) patients died during hospitalization and two were lost to follow-up. Ten out of 12 (78.6%) had persisting neurological symptoms on discharge.
Despite non-multiresistant MT strains, the case fatality rate among TE patients was high in our series. Early brain imaging is poor contributive for the diagnosis of TE.
Keywords
Adult, Antitubercular Agents/therapeutic use, Blood Glucose/analysis, Brain/pathology, Brain Damage, Chronic/epidemiology, Brain Damage, Chronic/etiology, Cerebrospinal Fluid Proteins/analysis, Drug Therapy, Combination, Encephalitis/diagnosis, Encephalitis/drug therapy, Encephalitis/epidemiology, Encephalitis/metabolism, Encephalitis/microbiology, Encephalitis, Viral/epidemiology, Female, France/epidemiology, Glucose/cerebrospinal fluid, Hospitalization/statistics & numerical data, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neuroimaging, Treatment Outcome, Tuberculosis, Central Nervous System/diagnosis, Tuberculosis, Central Nervous System/drug therapy, Tuberculosis, Central Nervous System/epidemiology, Tuberculosis, Central Nervous System/metabolism, Tuberculosis, Multidrug-Resistant/epidemiology, Young Adult, Encephalitis, Encéphalite, Tuberculose, Tuberculosis
Pubmed
Web of science
Create date
07/07/2023 11:04
Last modification date
27/02/2024 8:18
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