Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review
Background Tuberculous meningitis (TBM) is the most frequent, severe, and disabling form of central nervous system (CNS) tuberculosis (TB). TBM paradoxical manifestations are characterized by clinical or paraclinical worsening after 1 month of effective anti-TB treatment in patients who initially re...
Gespeichert in:
Veröffentlicht in: | Neurological sciences 2022-04, Vol.43 (4), p.2699-2708 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 2708 |
---|---|
container_issue | 4 |
container_start_page | 2699 |
container_title | Neurological sciences |
container_volume | 43 |
creator | Domínguez-Moreno, Rogelio García-Grimshaw, Miguel Medina-Julio, David Cantú-Brito, Carlos González-Duarte, Alejandra |
description | Background
Tuberculous meningitis (TBM) is the most frequent, severe, and disabling form of central nervous system (CNS) tuberculosis (TB). TBM paradoxical manifestations are characterized by clinical or paraclinical worsening after 1 month of effective anti-TB treatment in patients who initially responded to treatment despite the use of adjunctive corticosteroids.
Methods
Retrospective descriptive study of consecutive HIV-negative adult patients (≥ 18 years) with definitive TBM who developed a paradoxical manifestation following anti-TB in a tertiary-care hospital in Mexico from 2009 to 2019; we also conducted a literature review of published cases/series of paradoxical manifestations in HIV-negative patients from 1980 to 2020.
Results
We detected 84 cases of definitive TBM; 55 (68.7%) HIV-negative patients and 29 (36.3%) HIV-infected patients. Among HIV-negative patients, four (7.3%), three female and one male (19–49 years old), developed a paradoxical manifestation within 4–14 weeks following treatment initiation despite receiving adequate corticosteroid doses;
Mycobacterium bovis
was isolated from the cerebrospinal fluid of three cases and
Mycobacterium tuberculosis
in one more. Two patients developed vasculopathy-related cerebral infarctions, one severe basilar meningitis, and hydrocephalus, one more a tuberculoma. Two were treated with intravenous cyclophosphamide, and two with steroids. One of the patients treated with steroids died; patients who received cyclophosphamide had a good clinical response.
Conclusions
This case series illustrates the diverse clinical/radiologic paradoxical manifestations of TBM in HIV-negative patients. Cyclophosphamide may be safe and effective in treating TBM-associated paradoxical manifestations. Specific diagnostic and care protocols for these patients are needed. |
doi_str_mv | 10.1007/s10072-021-05693-2 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2586992675</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2586992675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-33e8cf0ddcaecfaab44513af6300ea51329970f22d4493b71554ef4b36e6fc763</originalsourceid><addsrcrecordid>eNp9kctuFjEMhSMEoqXwAixQJDZsBnKdzLBDFdBKlWABbKNM4lSp5kaSaemT8Lr4vwASCzaxHX_HiXUIec7Za86YeVN2p2iY4A3TbS8b8YCcct2zRirTPTzmvDPqhDwp5YYxxhWXj8kJ9pnmojslPz-77MLyI3k30snNKUKprqZlLjRsOc3XtG4DZL-Ny1boBDNepZoKrRlcxbpSNy2IXVx-a2a4Ru0t0BUDtspb6miGmpeygt93AhSf07rPS93CPXVzoGOqkF3dMiB-m-DuKXkU3Vjg2TGeka8f3n85v2iuPn28PH931XhpdG2khM5HFoJ34KNzg1KaSxdbyRg4TEXfGxaFCEr1cjBcawVRDbKFNnrTyjPy6jB3zcv3DXe3UyoextHNgAtbobu270VrNKIv_0Fvli3P-DsrWtlJrnojkRIHyuPSJUO0a06Ty_eWM7szzB5ss2ib3dtmBYpeHEdvwwThj-S3TwjIA1DWnSeQ_779n7G_AIGSpy8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2638314973</pqid></control><display><type>article</type><title>Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review</title><source>MEDLINE</source><source>SpringerLink (Online service)</source><creator>Domínguez-Moreno, Rogelio ; García-Grimshaw, Miguel ; Medina-Julio, David ; Cantú-Brito, Carlos ; González-Duarte, Alejandra</creator><creatorcontrib>Domínguez-Moreno, Rogelio ; García-Grimshaw, Miguel ; Medina-Julio, David ; Cantú-Brito, Carlos ; González-Duarte, Alejandra</creatorcontrib><description>Background
Tuberculous meningitis (TBM) is the most frequent, severe, and disabling form of central nervous system (CNS) tuberculosis (TB). TBM paradoxical manifestations are characterized by clinical or paraclinical worsening after 1 month of effective anti-TB treatment in patients who initially responded to treatment despite the use of adjunctive corticosteroids.
Methods
Retrospective descriptive study of consecutive HIV-negative adult patients (≥ 18 years) with definitive TBM who developed a paradoxical manifestation following anti-TB in a tertiary-care hospital in Mexico from 2009 to 2019; we also conducted a literature review of published cases/series of paradoxical manifestations in HIV-negative patients from 1980 to 2020.
Results
We detected 84 cases of definitive TBM; 55 (68.7%) HIV-negative patients and 29 (36.3%) HIV-infected patients. Among HIV-negative patients, four (7.3%), three female and one male (19–49 years old), developed a paradoxical manifestation within 4–14 weeks following treatment initiation despite receiving adequate corticosteroid doses;
Mycobacterium bovis
was isolated from the cerebrospinal fluid of three cases and
Mycobacterium tuberculosis
in one more. Two patients developed vasculopathy-related cerebral infarctions, one severe basilar meningitis, and hydrocephalus, one more a tuberculoma. Two were treated with intravenous cyclophosphamide, and two with steroids. One of the patients treated with steroids died; patients who received cyclophosphamide had a good clinical response.
Conclusions
This case series illustrates the diverse clinical/radiologic paradoxical manifestations of TBM in HIV-negative patients. Cyclophosphamide may be safe and effective in treating TBM-associated paradoxical manifestations. Specific diagnostic and care protocols for these patients are needed.</description><identifier>ISSN: 1590-1874</identifier><identifier>EISSN: 1590-3478</identifier><identifier>DOI: 10.1007/s10072-021-05693-2</identifier><identifier>PMID: 34705128</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Antitubercular Agents - therapeutic use ; Central nervous system ; Cerebrospinal fluid ; Corticosteroids ; Cyclophosphamide ; Female ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; Hydrocephalus ; Intravenous administration ; Literature reviews ; Male ; Medicine ; Medicine & Public Health ; Meningitis ; Middle Aged ; Mycobacterium tuberculosis ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Original Article ; Patients ; Psychiatry ; Retrospective Studies ; Steroid hormones ; Steroids ; Tuberculoma ; Tuberculosis ; Tuberculosis, Meningeal - cerebrospinal fluid ; Tuberculosis, Meningeal - complications ; Tuberculosis, Meningeal - drug therapy ; Vascular diseases ; Young Adult</subject><ispartof>Neurological sciences, 2022-04, Vol.43 (4), p.2699-2708</ispartof><rights>Fondazione Società Italiana di Neurologia 2021</rights><rights>2021. Fondazione Società Italiana di Neurologia.</rights><rights>Fondazione Società Italiana di Neurologia 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-33e8cf0ddcaecfaab44513af6300ea51329970f22d4493b71554ef4b36e6fc763</citedby><cites>FETCH-LOGICAL-c375t-33e8cf0ddcaecfaab44513af6300ea51329970f22d4493b71554ef4b36e6fc763</cites><orcidid>0000-0002-3654-7521 ; 0000-0001-7494-2015 ; 0000-0002-2434-9560 ; 0000-0001-5287-1068 ; 0000-0003-2788-8743</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10072-021-05693-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10072-021-05693-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34705128$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Domínguez-Moreno, Rogelio</creatorcontrib><creatorcontrib>García-Grimshaw, Miguel</creatorcontrib><creatorcontrib>Medina-Julio, David</creatorcontrib><creatorcontrib>Cantú-Brito, Carlos</creatorcontrib><creatorcontrib>González-Duarte, Alejandra</creatorcontrib><title>Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review</title><title>Neurological sciences</title><addtitle>Neurol Sci</addtitle><addtitle>Neurol Sci</addtitle><description>Background
Tuberculous meningitis (TBM) is the most frequent, severe, and disabling form of central nervous system (CNS) tuberculosis (TB). TBM paradoxical manifestations are characterized by clinical or paraclinical worsening after 1 month of effective anti-TB treatment in patients who initially responded to treatment despite the use of adjunctive corticosteroids.
Methods
Retrospective descriptive study of consecutive HIV-negative adult patients (≥ 18 years) with definitive TBM who developed a paradoxical manifestation following anti-TB in a tertiary-care hospital in Mexico from 2009 to 2019; we also conducted a literature review of published cases/series of paradoxical manifestations in HIV-negative patients from 1980 to 2020.
Results
We detected 84 cases of definitive TBM; 55 (68.7%) HIV-negative patients and 29 (36.3%) HIV-infected patients. Among HIV-negative patients, four (7.3%), three female and one male (19–49 years old), developed a paradoxical manifestation within 4–14 weeks following treatment initiation despite receiving adequate corticosteroid doses;
Mycobacterium bovis
was isolated from the cerebrospinal fluid of three cases and
Mycobacterium tuberculosis
in one more. Two patients developed vasculopathy-related cerebral infarctions, one severe basilar meningitis, and hydrocephalus, one more a tuberculoma. Two were treated with intravenous cyclophosphamide, and two with steroids. One of the patients treated with steroids died; patients who received cyclophosphamide had a good clinical response.
Conclusions
This case series illustrates the diverse clinical/radiologic paradoxical manifestations of TBM in HIV-negative patients. Cyclophosphamide may be safe and effective in treating TBM-associated paradoxical manifestations. Specific diagnostic and care protocols for these patients are needed.</description><subject>Adult</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Central nervous system</subject><subject>Cerebrospinal fluid</subject><subject>Corticosteroids</subject><subject>Cyclophosphamide</subject><subject>Female</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Intravenous administration</subject><subject>Literature reviews</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meningitis</subject><subject>Middle Aged</subject><subject>Mycobacterium tuberculosis</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Original Article</subject><subject>Patients</subject><subject>Psychiatry</subject><subject>Retrospective Studies</subject><subject>Steroid hormones</subject><subject>Steroids</subject><subject>Tuberculoma</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Meningeal - cerebrospinal fluid</subject><subject>Tuberculosis, Meningeal - complications</subject><subject>Tuberculosis, Meningeal - drug therapy</subject><subject>Vascular diseases</subject><subject>Young Adult</subject><issn>1590-1874</issn><issn>1590-3478</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kctuFjEMhSMEoqXwAixQJDZsBnKdzLBDFdBKlWABbKNM4lSp5kaSaemT8Lr4vwASCzaxHX_HiXUIec7Za86YeVN2p2iY4A3TbS8b8YCcct2zRirTPTzmvDPqhDwp5YYxxhWXj8kJ9pnmojslPz-77MLyI3k30snNKUKprqZlLjRsOc3XtG4DZL-Ny1boBDNepZoKrRlcxbpSNy2IXVx-a2a4Ru0t0BUDtspb6miGmpeygt93AhSf07rPS93CPXVzoGOqkF3dMiB-m-DuKXkU3Vjg2TGeka8f3n85v2iuPn28PH931XhpdG2khM5HFoJ34KNzg1KaSxdbyRg4TEXfGxaFCEr1cjBcawVRDbKFNnrTyjPy6jB3zcv3DXe3UyoextHNgAtbobu270VrNKIv_0Fvli3P-DsrWtlJrnojkRIHyuPSJUO0a06Ty_eWM7szzB5ss2ib3dtmBYpeHEdvwwThj-S3TwjIA1DWnSeQ_779n7G_AIGSpy8</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Domínguez-Moreno, Rogelio</creator><creator>García-Grimshaw, Miguel</creator><creator>Medina-Julio, David</creator><creator>Cantú-Brito, Carlos</creator><creator>González-Duarte, Alejandra</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3654-7521</orcidid><orcidid>https://orcid.org/0000-0001-7494-2015</orcidid><orcidid>https://orcid.org/0000-0002-2434-9560</orcidid><orcidid>https://orcid.org/0000-0001-5287-1068</orcidid><orcidid>https://orcid.org/0000-0003-2788-8743</orcidid></search><sort><creationdate>20220401</creationdate><title>Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review</title><author>Domínguez-Moreno, Rogelio ; García-Grimshaw, Miguel ; Medina-Julio, David ; Cantú-Brito, Carlos ; González-Duarte, Alejandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-33e8cf0ddcaecfaab44513af6300ea51329970f22d4493b71554ef4b36e6fc763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Central nervous system</topic><topic>Cerebrospinal fluid</topic><topic>Corticosteroids</topic><topic>Cyclophosphamide</topic><topic>Female</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Hydrocephalus</topic><topic>Intravenous administration</topic><topic>Literature reviews</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meningitis</topic><topic>Middle Aged</topic><topic>Mycobacterium tuberculosis</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Original Article</topic><topic>Patients</topic><topic>Psychiatry</topic><topic>Retrospective Studies</topic><topic>Steroid hormones</topic><topic>Steroids</topic><topic>Tuberculoma</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Meningeal - cerebrospinal fluid</topic><topic>Tuberculosis, Meningeal - complications</topic><topic>Tuberculosis, Meningeal - drug therapy</topic><topic>Vascular diseases</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Domínguez-Moreno, Rogelio</creatorcontrib><creatorcontrib>García-Grimshaw, Miguel</creatorcontrib><creatorcontrib>Medina-Julio, David</creatorcontrib><creatorcontrib>Cantú-Brito, Carlos</creatorcontrib><creatorcontrib>González-Duarte, Alejandra</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Family Health Database (Proquest)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Psychology Database (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Domínguez-Moreno, Rogelio</au><au>García-Grimshaw, Miguel</au><au>Medina-Julio, David</au><au>Cantú-Brito, Carlos</au><au>González-Duarte, Alejandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review</atitle><jtitle>Neurological sciences</jtitle><stitle>Neurol Sci</stitle><addtitle>Neurol Sci</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>43</volume><issue>4</issue><spage>2699</spage><epage>2708</epage><pages>2699-2708</pages><issn>1590-1874</issn><eissn>1590-3478</eissn><abstract>Background
Tuberculous meningitis (TBM) is the most frequent, severe, and disabling form of central nervous system (CNS) tuberculosis (TB). TBM paradoxical manifestations are characterized by clinical or paraclinical worsening after 1 month of effective anti-TB treatment in patients who initially responded to treatment despite the use of adjunctive corticosteroids.
Methods
Retrospective descriptive study of consecutive HIV-negative adult patients (≥ 18 years) with definitive TBM who developed a paradoxical manifestation following anti-TB in a tertiary-care hospital in Mexico from 2009 to 2019; we also conducted a literature review of published cases/series of paradoxical manifestations in HIV-negative patients from 1980 to 2020.
Results
We detected 84 cases of definitive TBM; 55 (68.7%) HIV-negative patients and 29 (36.3%) HIV-infected patients. Among HIV-negative patients, four (7.3%), three female and one male (19–49 years old), developed a paradoxical manifestation within 4–14 weeks following treatment initiation despite receiving adequate corticosteroid doses;
Mycobacterium bovis
was isolated from the cerebrospinal fluid of three cases and
Mycobacterium tuberculosis
in one more. Two patients developed vasculopathy-related cerebral infarctions, one severe basilar meningitis, and hydrocephalus, one more a tuberculoma. Two were treated with intravenous cyclophosphamide, and two with steroids. One of the patients treated with steroids died; patients who received cyclophosphamide had a good clinical response.
Conclusions
This case series illustrates the diverse clinical/radiologic paradoxical manifestations of TBM in HIV-negative patients. Cyclophosphamide may be safe and effective in treating TBM-associated paradoxical manifestations. Specific diagnostic and care protocols for these patients are needed.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>34705128</pmid><doi>10.1007/s10072-021-05693-2</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-3654-7521</orcidid><orcidid>https://orcid.org/0000-0001-7494-2015</orcidid><orcidid>https://orcid.org/0000-0002-2434-9560</orcidid><orcidid>https://orcid.org/0000-0001-5287-1068</orcidid><orcidid>https://orcid.org/0000-0003-2788-8743</orcidid></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1590-1874 |
ispartof | Neurological sciences, 2022-04, Vol.43 (4), p.2699-2708 |
issn | 1590-1874 1590-3478 |
language | eng |
recordid | cdi_proquest_miscellaneous_2586992675 |
source | MEDLINE; SpringerLink (Online service) |
subjects | Adult Antitubercular Agents - therapeutic use Central nervous system Cerebrospinal fluid Corticosteroids Cyclophosphamide Female HIV HIV Infections - complications HIV Infections - drug therapy Human immunodeficiency virus Humans Hydrocephalus Intravenous administration Literature reviews Male Medicine Medicine & Public Health Meningitis Middle Aged Mycobacterium tuberculosis Neurology Neuroradiology Neurosciences Neurosurgery Original Article Patients Psychiatry Retrospective Studies Steroid hormones Steroids Tuberculoma Tuberculosis Tuberculosis, Meningeal - cerebrospinal fluid Tuberculosis, Meningeal - complications Tuberculosis, Meningeal - drug therapy Vascular diseases Young Adult |
title | Paradoxical manifestations during tuberculous meningitis treatment among HIV-negative patients: a retrospective descriptive study and literature review |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T06%3A19%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Paradoxical%20manifestations%20during%20tuberculous%20meningitis%20treatment%20among%20HIV-negative%20patients:%20a%20retrospective%20descriptive%20study%20and%20literature%20review&rft.jtitle=Neurological%20sciences&rft.au=Dom%C3%ADnguez-Moreno,%20Rogelio&rft.date=2022-04-01&rft.volume=43&rft.issue=4&rft.spage=2699&rft.epage=2708&rft.pages=2699-2708&rft.issn=1590-1874&rft.eissn=1590-3478&rft_id=info:doi/10.1007/s10072-021-05693-2&rft_dat=%3Cproquest_cross%3E2586992675%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2638314973&rft_id=info:pmid/34705128&rfr_iscdi=true |