Tuberculous and brucellosis meningitis differential diagnosis

被引:16
|
作者
Erdem, Hakan [1 ]
Senbayrak, Seniha [2 ]
Gencer, Serap [3 ]
Hasbun, Rodrigo [4 ]
Karahocagil, Mustafa Kasim [5 ]
Sengoz, Gonul [6 ]
Karsen, Hasan [7 ]
Kaya, Selcuk [8 ]
Civljak, Rok [9 ]
Inal, Ayse Seza [10 ]
Pekok, Abdullah Umut [11 ]
Celen, Mustafa Kemal [12 ]
Deniz, Secil [2 ]
Ulug, Mehmet [13 ]
Demirdal, Tuna [14 ]
Namiduru, Mustafa [15 ]
Tekin, Recep [12 ]
Guven, Tumer [16 ]
Parlak, Emine [17 ]
Bolukcu, Sibel [18 ]
Avci, Meltem [19 ]
Sipahi, Oguz Rept [18 ]
Nayman-Alpat, Saygin [20 ]
Yasar, Kadriye [21 ]
Pehlivanoglu, Filiz [6 ]
Yilmaz, Emel [22 ]
Ates-Guler, Selma [23 ]
Mutlu-Yilmaz, Esmeray [24 ]
Tosun, Selma [19 ]
Sirmatel, Fatma [25 ]
Sahin-Horasan, Elif [26 ]
Akbulut, Ayhan [27 ]
Johansen, Isik Sorpuncu [28 ]
Simeon, Soline [29 ]
Batirel, Ayse [3 ]
Oztoprak, Nefise [30 ]
Cag, Yasemin [3 ]
Catroux, Melanie [31 ]
Hansmann, Yves [32 ]
Kadanali, Ayten [33 ]
Turgut, Huseyin [34 ]
Baran, Ali Irfan [5 ]
Gul, Hanefi Cem [35 ]
Karaahmetoglu, Gokhan [1 ]
Sunnetcioglu, Mahmut [5 ]
Haykir-Solay, Asli [36 ]
Denk, Affan
Ayaz, Celal
Kose, Sukran [37 ]
Gorenek, Levent [1 ]
机构
[1] GATA Haydarpasa Asker Hastanesi, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[2] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[3] Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[4] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Infect Dis, Houston, TX USA
[5] Yuzuncu Yil Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Van, Turkey
[6] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[7] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey
[8] Karadeniz Tech Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Trabzon, Turkey
[9] Univ Zagreb, Dr Fran Mihaljev Univ Hosp Infect Dis, Dept Infect Dis, Sch Med, Zagreb, Croatia
[10] Cukurova Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Adana, Turkey
[11] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey
[12] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey
[13] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey
[14] Katip Celebi Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Izmir, Turkey
[15] Gaziantep Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Gaziantep, Turkey
[16] Ankara Ataturk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey
[17] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey
[18] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[19] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey
[20] Osmangazi Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Eskisehir, Turkey
[21] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[22] Uludag Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Bursa, Turkey
[23] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey
[24] Samsun Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Samsun, Turkey
[25] Abant Izzet Baysal Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Bolu, Turkey
[26] Mersin Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Mersin, Turkey
[27] Firat Univ, Dept Infect Dis & Clin Microbiol, Sch Med, TR-23169 Elazig, Turkey
[28] Odense Univ Hosp, Dept Infect Dis Q, DK-5000 Odense, Denmark
[29] Univ Hosp Pontchaillou, Dept Infect & Trop Dis, Rennes, France
[30] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey
[31] Univ Poitiers Hosp, Dept Infect Dis, Poitiers, France
[32] Univ Hosp, Dept Infect Dis, Strasbourg, France
[33] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey
[34] Pamukkale Univ, Dept Infect Dis & Clin Microbiol, Sch Med, Denizli, Turkey
[35] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey
[36] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey
[37] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey
关键词
Brucellosis; Tuberculosis; Meningitis; Diagnosis; NEUROBRUCELLOSIS;
D O I
10.1016/j.tmaid.2015.02.008
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the differential diagnosis of TBM when these two systems suggest the presence of TBM. Method: BME and TBM patients from 35 tertiary hospitals were included in this study. Overall 294 adult patients with BME and 190 patients with TBM were enrolled. All patients involved in the study had microbiological confirmation for either TBM or BME. Finally, the Thwaites and Lancet scoring systems were assessed in both groups. Results: The Thwaites scoring system more frequently predicted BME cases (n = 292, 99.3%) compared to the TBM group (n = 182, 95.8%) (P = 0.017). According to the Lancet scoring system, the mean scores for BME and TBM were 9.43 +/- 1.71 and 11.45 +/- 3.01, respectively (P < 0.001). In addition, TBM cases were classified into "probable" category more significantly compared to BME cases, and BME cases were categorized into the "possible" category more frequently. Conclusions: When the Thwaites or Lancet scoring systems indicate TBM, brucellar etiology should also be taken into consideration particularly in endemic countries. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:185 / 191
页数:7
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