Efficacy of Intrathecal Isoniazid and Steroid Therapy in Refractory Tuberculous Meningitis

被引：2

作者：

Ashizawa, Nobuyuki ^{[1
,2
]}

Kubo, Ryotaro ^{[2
]}

Tagawa, Ryuta ^{[2
,3
]}

Ito, Yuya ^{[2
]}

Takeda, Kazuaki ^{[2
]}

Ide, Shotaro ^{[4
]}

Iwanaga, Naoki ^{[2
]}

Fujita, Ayumi ^{[1
]}

Tashiro, Masato ^{[1
,5
]}

Takazono, Takahiro ^{[2
,5
]}

Tanaka, Takeshi ^{[1
]}

Nagaoka, Atsushi ^{[6
]}

Yoshimura, Shunsuke ^{[6
]}

Ujifuku, Kenta ^{[7
]}

Koga, Tomohiro ^{[8
]}

Ishii, Koji ^{[9
,10
]}

Yamamoto, Kazuko ^{[2
,11
]}

Furumoto, Akitsugu ^{[4
]}

Izumikawa, Koichi ^{[1
,5
]}

Yanagihara, Katsunori ^{[12
]}

Mukae, Hiroshi ^{[2
]}

机构：

[1] Nagasaki Univ Hosp, Infect Control & Educ Ctr, Nagasaki, Japan

[2] Nagasaki Univ Hosp, Dept Resp Med, Nagasaki, Japan

[3] Sasebo City Gen Hosp, Dept Resp Med, Sasebo, Japan

[4] Nagasaki Univ Hosp, Infect Dis Experts Training Ctr, Nagasaki, Japan

[5] Nagasaki Univ, Grad Sch Biomed Sci, Dept Infect Dis, Nagasaki, Japan

[6] Nagasaki Univ Hosp, Dept Neurol & Strokol, Nagasaki, Japan

[7] Nagasaki Univ, Grad Sch Biomed Sci, Dept Neurosurg, Nagasaki, Japan

[8] Nagasaki Univ, Grad Sch Biomed Sci, Dept Immunol & Rheumatol, Div Adv Prevent Med Sci, Nagasaki, Japan

[9] Nagasaki Univ, Sch Med, Dept Anesthesiol, Nagasaki, Japan

[10] Nagasaki Univ Hosp, Palliat Care Ctr, Nagasaki, Japan

[11] Univ Ryukyus, Grad Sch Med, Div Infect Resp & Digest Med, Nishihara, Japan

[12] Nagasaki Univ, Grad Sch Biomed Sci, Dept Lab Med, Nagasaki, Japan

来源：

INTERNAL MEDICINE | 2024年 / 63卷 / 04期

关键词：

tuberculous meningitis; intrathecal injection; neuropsychiatric systemic lupus erythematosus (NPSLE);

D O I：

10.2169/internalmedicine.1917-23

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Tuberculous meningitis is an infectious disease with high mortality. Literature describing intrathecal therapy for tuberculous meningitis is scarce. We herein report a case of refractory tuberculous meningitis in a 52year-old woman with underlying neuropsychiatric systemic lupus erythematosus. Despite systemic treatment with anti-tuberculosis drugs and dexamethasone, her meningeal irritation deteriorated. Intrathecal isoniazid and prednisolone administration was therefore initiated, and the symptoms of severe meningeal irritation improved along with head magnetic resonance imaging and cerebrospinal fluid findings. This case report highlights the efficacy of intrathecal isoniazid and steroid injections for refractory tuberculous meningitis, particularly in patients with severe meningeal irritation.

引用

页码：583 / 586

页数：4

共 50 条

[1] Intrathecal Isoniazid for Refractory Tuberculous Meningitis with Cerebral Infarction
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Yamawaki, Mika
Sakata, Ryoichi
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Nakayasu, Hiroyuki
Nakashima, Kenji
[J]. INTERNAL MEDICINE, 2017, 56 (08) : 953 - 957
[2] INTRATHECAL ISONIAZID IN TUBERCULOUS MENINGITIS
SWIFT, PN
[J]. ARCHIVES OF DISEASE IN CHILDHOOD, 1956, 31 (158) : 328 - 332
[3] TUBERCULOUS MENINGITIS DURING ISONIAZID THERAPY
ROBINS, AB
[J]. AMERICAN REVIEW OF TUBERCULOSIS AND PULMONARY DISEASES, 1956, 74 (03): : 480 - 480
[4] TUBERCULOUS MENINGITIS TREATED WITH ACTH AND ISONIAZID - A COMPARISON WITH INTRATHECAL STREPTOMYCIN
BULKELEY, WCM
[J]. BMJ-BRITISH MEDICAL JOURNAL, 1953, 2 (4846): : 1127 - 1129
[5] Efficacy and safety of intrathecal dexamethasone combined with isoniazid in the treatment of tuberculous meningitis: a meta-analysis
Gao, Yan
Su, Jinwen
Ma, Yuxiang
Sun, Yunliang
Cui, Jiyong
Jin, Xianhe
Li, Yuxi
Chen, Zhi
[J]. BMC NEUROLOGY, 2024, 24 (01)
[6] TUBERCULOUS MENINGITIS DEVELOPING IN THE COURSE OF ISONIAZID THERAPY
LINCOLN, EM
LYTHCOTT, GI
[J]. AMERICAN REVIEW OF TUBERCULOSIS AND PULMONARY DISEASES, 1956, 73 (06): : 940 - 943
[7] THE TREATMENT OF TUBERCULOUS MENINGITIS WITHOUT INTRATHECAL THERAPY
SMELLIE, JM
[J]. LANCET, 1954, 2 (NOV27): : 1091 - 1093
[8] Steroid therapy in children with tuberculous meningitis
Shah, Ira
[J]. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES, 2009, 41 (6-7) : 532 - 534
[9] EVALUATION OF INTRATHECAL THERAPY WITH STREPTOMYCIN AND HYDROCORTISONE IN TUBERCULOUS MENINGITIS
FREIMAN, I
GEEFHUYSEN, J
[J]. JOURNAL OF PEDIATRICS, 1970, 76 (06): : 895 - +
[10] ISONIAZID FOR TREATMENT OF TUBERCULOUS MENINGITIS
ROBINSON, A
MIDDLEBROOK, G
[J]. PEDIATRICS, 1958, 21 (01) : 162 - 162

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