Roca V, Sanchez-Portocarrero J, Martin T, Perez-Cecilia E, de la Torre F, Picazo JJ, Fernandez-Cruz A; International Conference on AIDS.
Int Conf AIDS. 1994 Aug 7-12; 10: 200 (abstract no. PB0230).
Hospital Universitario San Carlos, Madrid, Spain.
We report five cases of Persistent Neutrophilic Meningitis (PNM), diagnosed in base of case-definition criteria proposed by J. E. Peacock (persistent neutrophilic pleocytosis in CSF for more than 7 days, despite to be treated with appropriate antimicrobial regime), and accounted in patients with HIV-infection. In 4 the responsible etiological microorganism of PNM was M. tuberculosis and one it was C. albicans. All were parenteral drug addicts (4 man y 1 women) with severely impaired immunity: CD4+ lymphocyte count were below of 100 by milliliter in four of them. Three of four patients with M. tuberculosis meningitis had been previously diagnosed and incompletely treated (due to self-discontinuation) with 4 drugs (isoniazid, rifampin, ethambutol and pyrazinamide) for an episode of pulmonary or disseminated tuberculosis. Headache was the more constant symptom, present in all. Fever was present in only 4, stiff neck in 3/5, CT alterations in 3/5, nausea and or vomiting in 2/5, obnubilation or cognitive impairment 2/5 and another infection of central nervous system (toxoplasmosis) in 1/5. So, we think that the concept of PNM is a good predictor of etiological responsible agent of meningitis, and, in our geographic area, is closely and more frequently related, in HIV-positive patients, with M. tuberculosis.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ethambutol
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Isoniazid
- Male
- Meningitis
- Pyrazinamide
- Rifampin
- Toxoplasmosis
- Tuberculosis
- Tuberculosis, Meningeal
Other ID:
UI: 102208507
From Meeting Abstracts