Abstract
Although it is believed that in the western countries tuberculosis is a disease confined to high-risk groups such as immigrants, we describe four cases of tuberculous meningitis (TBM) in native Dutch children. The inverse relation between the delay in starting therapy and the clinical outcome makes early diagnosis of TBM essential. The often non-specific presenting symptoms and laboratory results, the time-consuming character of cultures and the unfamiliarity of western medical staff with the disease all may contribute to a delay in diagnosis of TBM. We believe that especially gadolinium-enhanced MRI or contrast-enhanced CT can be very helpful in the early diagnosis. Although not specific, hydrocephalus and basal meningeal enhancement on MRI or CT, together with the clinical suspicion can suggest the diagnosis to such an extent that there is enough reason to start antituberculous treatment.
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Samuel AM, Vidvans AS (1987) Radionuclide scintigraphy of the brain and ultrasound studies in tubercular meningitis. Clin Nucl Med 12: 298–302
Wallace RC, Burton EM, Barrett FF, Leggiadro RJ, Gerald BE, Lasater OE (1991) Intracranial tuberculosis in children: CT appearance and clinical outcome. Pediatr Radiol 21: 241–246
Gupta RK, Gupta S, Singh D, Sharma B, Kohli A, Gujral RB (1994) MR imaging and angiography in tuberculous meningitis. Neuroradiology 36: 87–92
Clark WC, Metcalf JC Jr, Muhlbauer MS, Dohan FC Jr, Robertson JH (1986)Mycobacterium tuberculosis meningitis: a report of twelve cases and a literature review. Neurosurgery 18: 604–610
Draouat S, Abdenabi B, Ghanem M, Bourjat P (1987) Computed tomography of cerebral tuberculoma. J Comput Assist Tomogr 11: 594–597
Smelt AHM, Roldaan AC, van Furth R (1989) Pulmonary and extrapulmonary tuberculosis: clinical experience in the 1980's (in Dutch). Ned Tijdschr Geneeskd 133: 66–70
Sluiter HJ, Knol K (1989) Tuberculosis in the Netherlands in 1988 (in Dutch). Ned Tijdschr Geneeskd 133: 59–60
Kumar A, Montanera W, Willinsky R, TerBrugge KG, Aggarwal S (1993) MR features of tuberculous arachnoiditis. J Comput Assist Tomogr 17:127–130
Demaerel P, Wilms G, Marchal G (1990) MRI findings in tuberculous meningo-encephalitis. Rofo Fortschr Geb Rontgenstr Nuklearmed 152: 384–387
Jinkins JR (1987) Dynamic CT of tuberculous meningeal reactions. Neuroradiology 29: 343–347
Chang KH, Han MH, Roh JK, Kim IO, Han MC, Kim CW (1990) Gd-DTPA-enhanced MR imaging of the brain in patients with meningitis: comparison with CT. Am J Roentgenol 154: 809–816
Chang KH, Han MH, Roh JK, Kim IO, Han MC, Choi KS, Kim CW (1990) Gd-DTPA enhanced MR imaging in intracranial tuberculosis. Neuroradiology 32: 19–25
Schroth G, Kretzschmar K, Gawehn J, Voigt K (1987) Advantage of magnetic resonance imaging in the diagnosis of cerebral infections. Neuroradiology 29: 120–126
Uhlenbrock D, Sehlen S, Dannenmaier B (1990) Intrakranielle Verkalkungenwelche Mehrinformation bietet das MR gegenüber dem CT? Rofo Fortschr Geb Rontgenstr Nuklearmed 153: 22–28
Villoria MF, de la Torre J, Fortea F, Munoz L, Hernandez T, Alarcon JJ (1992) Intracranial tuberculosis in AIDS: CT and MRI findings. Neuroradiology 34: 11–14
Trautmann M, Kluge W, Otto HS, Loddenkemper R (1986) Computed tomography in CNS tuberculosis. Eur Neurol 25: 91–97
Kioumehr F, Dadsetan MR, Rooholamini SA, Au A (1994) Central nervous system tuberculosis: MRI. Neuroradiology 36: 93–96
Theunissen PHMH, Blaauw G, Stefanko SZ (1989) Intracranial tuberculoma (in Dutch). Ned Tijdschr Geneeskd 133: 2330–2333
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Hooijboer, P.G.A., van der Vliet, A.M. & Sinnige, L.G.F. Tuberculous meningitis in native Dutch children: A report of four cases. Pediatr Radiol 26, 542–546 (1996). https://doi.org/10.1007/BF01372238
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DOI: https://doi.org/10.1007/BF01372238