Central system nervous tuberculosis in infants

J Child Neurol. 2010 Jan;25(1):102-6. doi: 10.1177/0883073809336129.

Abstract

The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. In this report, we reviewed the clinical features and laboratory findings of 6 infants with central system nervous tuberculosis during a 10-year period. One of the patients had multifocal tuberculosis. The mean time to the diagnosis was 32 +/- 13.4 days. A contact source was identified in only 2 patients. All 6 patients had abnormal cerebrospinal fluid findings, less than 500 cells/microL with lymphocytic predominance. Computerized tomography (CT) and/or magnetic resonance imaging (MRI) revealed hydrocephalus with basal enhancement in 2 patients. One patient developed pontocerebellar and pituitary tuberculomas, which were responsible for compression and diabetes insipidus, 1 year after antituberculous treatment. These localizations are very rare. On the follow-up, 3 patients had hypoacousia and only 1 had severe sequelae, despite a diagnostic delay.

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Cerebellar Diseases / cerebrospinal fluid
  • Cerebellar Diseases / diagnosis
  • Cerebellar Diseases / pathology
  • Child, Preschool
  • Diabetes Insipidus / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hydrocephalus / cerebrospinal fluid
  • Hydrocephalus / diagnosis
  • Hydrocephalus / pathology
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Pituitary Diseases / cerebrospinal fluid
  • Pituitary Diseases / diagnosis
  • Pituitary Diseases / pathology
  • Pons / diagnostic imaging
  • Pons / pathology
  • Time Factors
  • Tomography, X-Ray Computed
  • Tuberculoma, Intracranial / cerebrospinal fluid
  • Tuberculoma, Intracranial / diagnosis
  • Tuberculoma, Intracranial / pathology
  • Tuberculosis, Central Nervous System / cerebrospinal fluid
  • Tuberculosis, Central Nervous System / diagnosis*
  • Tuberculosis, Central Nervous System / pathology