Clinical features and diagnosis of tuberculous meningoencephalitis in patients infected with human immunodeficiency virus
A. A. Milyaev , V. V. Dantsev , A. I. Belova , R. A. Platonova , B. V. Zaretsky , R. D. Muchaidze , V. G. Karpushchenko
Bulletin of the Russian Military Medical Academy ›› 2020, Vol. 22 ›› Issue (2) : 55 -58.
Clinical features and diagnosis of tuberculous meningoencephalitis in patients infected with human immunodeficiency virus
The results of a prospective study of 66 patients aged 32,6±3,8 years infected with the human immunodeficiency virus who were treated in an anti-tuberculosis medical organization for tuberculosis meningoencephalitis are presented. Of these, 49 (74,2%) were newly diagnosed with tuberculosis, and 17 (25,8%) had relapses and chronic forms of tuberculosis. According to social characteristics, patients were distributed as follows: working - 9 (13,6%), non-working - 57 (86,4%), disabled people with tuberculosis - 4 (6,1%), persons who previously served their sentences in prison - 48 (72,7%). All the surveyed patients had bad habits: they continued to actively use psychoactive substances - 52 (78,8%) people, abused alcohol - 43 (65,2%), smoked - 60 (90,1%). In 97% of cases, tuberculosis of the meninges and Central nervous system was a complication of respiratory tuberculosis: tuberculosis of the intra-thoracic lymph nodes - 42,4%, disseminated pulmonary tuberculosis - 27,3%, infiltrative pulmonary tuberculosis - 22,7%, and caseous pneumonia- 7,6%. The most effective method for diagnosing the tuberculosis etiology of meningoencephalitis in patients infected with the human immunodeficiency virus is the study of cerebrospinal fluid using a polymerase chain reaction. Deoxyribonucleic acid of Mycobacterium tuberculosis was detected in 31 (47%) patients. The characteristics of the cerebrospinal fluid in the examined patients are presented as follows: a decrease in glucose in 45 (68,2%) patients, an increase in protein in 59 (89,4%), and cytosis at the upper limit of normal values in 10 (15,6%). High mortality rates (47,7%) in patients infected with the human immunodeficiency virus in combination with tuberculosis meningoencephalitis are associated with a high degree of immunosuppression.
tuberculosis / human immunodeficiency virus / Mycobacterium tuberculosis / tuberculosis meningitis / meningoencephalitis / diagnostics / cerebrospinal fluid / polymerase chain reaction / mortality
| [1] |
Беляков, Н.А. ВИЧ-инфекция и центральная нервная система / Н.А. Беляков, Т.Н. Трофимова, В.В. Рассохина // Мед. темат. архив. – СПб.: Балт. мед. образовательный центр, 2013. С. 29-53. |
| [2] |
Бугакова, С.Л. Туберкулезный менингит. Вопросы патогенеза, клиники, диагностики, дифференциальной диагностики, лечения и исходов / С.Л. Бугакова. – Астана: Медицина, 2010. – 100 с. |
| [3] |
Зимина, В.Н. Туберкулёз и ВИЧ-инфекция у взрослых: руководство / В.Н. Зимина, В.А. Кошечкин, А.В. Кравченко. – М.: ГЭОТАР-Медиа, 2014. – 224 с. |
| [4] |
Нечаева, О.Б. Мониторинг туберкулеза и ВИЧ-инфекции в Российской Федерации / О.Б. Нечаева // Мед. алфавит. – 2017. – Т. 3, № 30 (327). – С. 24–33. |
| [5] |
Оперативный план по борьбе с ВИЧ-инфекцией. – ВОЗ, 2014.С. 1–33. |
| [6] |
Global tuberculоsis repоrt 2016 // WHО. – Geneva, 2016. – 214 p. |
| [7] |
Treatment of tuberculosis: guidelines for national programmes (2003) // WHО. – Geneva, 2003. – 40 p. |
| [8] |
World Health Organization: «Report of Lessons Learn» Workshop on the six ProTEST Pilot Projects in Malawi, South Africa and Zambia // WHO. – Geneva, 2004. – 40 p. |
Milyaev A.A., Dantsev V.V., Belova A.I., Platonova R.A., Zaretsky B.V., Muchaidze R.D., Karpushchenko V.G.
/
| 〈 |
|
〉 |
PDF
