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Abstract
Central Nervous System Tuberculosis In AIDS Patients
Solari R.1, De Carolis L.1, Corti M.1
Introduction: Central nervous system tuberculosis (CNS-TBC) is a severe complication of extrapulmonary TBC in AIDS patients. Most of these have tuberculous meningoencephalitis (10%); less common are focal brain lesions as tuberculomas (0.2 a 5%) and brain abscesses.
Methods: In this report we describe the epidemiological, clinical, microbiological, immunological and the survival in 31 patients with AIDS and CNS-TBC.
Results: We evaluated 31 HIV-seropositive patients; 22 were male; mean of age was 32.2 years. The mean of CD4 T cell count at the time of diagnosis was 107 cell/uL. Eighteen patients were intravenous drug abusers, 8 were heterosexual and 5 were homosexual. Meningoencephalitis was the most common clinical form of CNS-TBC with 26 cases; 4 were tuberculomas and we diagnosed only 1 abscess caused by MTBC. Diagnosis of CNS-TBC was made by the clinical manifestations and the culture of CSF in 10 patients; by the clinical manifestations, neuroimages and microbiological findings (direct detection or culture in others tissues or body fluids) in 19 patients. Fifteen patients had sputum cultures positive for MTBC; 2 had blood cultures positive and 1 had positive culture of supraclavicular adenopathy and the other one had positive culture of ascitis smear. Finally, cerebral abscess due to MTBC and 1 patient with tuberculoma were diagnosed by neuroimages, stereotactic biopsy and positive culture of CSF. The sensibility tests of antituberculous drugs was made in 13 patients; 3 were multidrug resistant and 7 were sensitive to all antiTBC drugs. One patient was resistant to streptomycin; 1 to rifampicin and pirazinamide and another 1 to isoniazid and ethambutol. Twelve patients (38.7 %) died during the hospitalization and 19 (61.3%) evidence a good clinical and neurological response to specific treatment.
Conclusions: CNS-TBC is a severe complication of advanced HIV/AIDS disease; we want to emphasize the importance of early diagnosis followed by specific therapy.
The 3rd IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
TuPe7.1C04
Suggested Citation
"SolariR., et al.
Central Nervous System Tuberculosis In AIDS Patients.
Poster Exhibition:
The 3rd IAS Conference on HIV Pathogenesis and Treatment:
Abstract no.
TuPe7.1C04"
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