Tüberküloz menenjitli 19 çocuk olgunun değerlendirilmesi
Yükleniyor...
Dosyalar
Tarih
1996
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma Atatürk Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Kliniğinde Ocak 1991-Ocak 1994 tarihleri arasında yatırılarak izlenen 19 tüberküloz menenjitli olgu üzerinde gerçekleştirildi. Olguların ortalama yaşı 55.5 ± 31.7 ay olup %68.4'ü kız idi. En sık görülen şikayetler ateş (%89.5), kusma (%57.9), ve dalgınlık (%42.1) idi. Sekiz olguda (%42.1) pozitif aile öyküsü, dört (%10.5) olguda PPD pozitifliği tesbit edildi. Başvurudaki ortalama beyin omurilik (BOS) protein düzeyi 160 mg/dl, BOS/serum glukoz oram %30.8, BOS
lökosit sayısı 148/mm3 ve % lenfosit 69±16 (25-100) bulunmuştur. 11 hastada (%57.9) tüberküloz lehine akciğer grafisi bulguları saptandı. 12 olguya bilgisayarlı beyin tomografisi(BBT) çektirilebildi, yedi(%58.3)'sinde hidrosefali tesbit edildi. Altı olguda bakılan adenozin deaminaz (ADA) seviyesi yüksekti (33.4+4.7 U/L) dört olgunun tanısı da polimeraz zincir reaksiyonu (PCR) ile doğrulandı. Beş hastada kültürde Mycobacterium Tuberculosis üredi. Başvuru esnasında iki (%10.5) olgu Evre I, sekiz (%42.1) olgu Evre II. dokuz (%47.4) olgu ise Evre III olup mortalite oranı %47.4 idi. Evre l'de sekel oranı % 100 iken Evre ll'de % 57.1 olarak bulundu. Tüberküloz menenenjitte mortalite ve morbiditeyi azaltmak açısından erken tanının önemi vurgulandı.
Nineteen cases with tuberculous meningitis were included in this study who were treated in Atatürk University Medical School Pediatrics Clinic between January 1991-1994. The mean age of the patients was 55.5± 31.7 months and 68.4% were females. The symptoms were fever(89.5%), vomiting(57.9%)and lethargy (42.1%). Family history was positive in eight cases (42.1%) and tuberculin skin test was positive in four cases (10.5%). The mean cerebrospinal fluid protein (CSF) level was 160mg/dl, CSF/serum glucose ratio was 30.8% and CSF leucocyte count was 148/mm. Chest radiographs were positive in 11 cases (57.9%). Twelve patients had computerized cranial tomography and hydrocephalus was demonstrated in seven (58.3%) of these patients. Adenosine deaminase activity was determined in six cases and all were high (33.4 ±4.7 U/L). The diagnosis of tuberculous menengitis was confirmed by polymerase chain reaction in four cases. Mycobacterium tuberculosis culture was positive in five of the nineteen cases. At admission two (10.5 %) cases were in Stage I, eight (42.1%) were in Stage II, and nine (47.4%) were in Stage III. Mortality ratio was 47.4% and it was highest in Stage III.
Nineteen cases with tuberculous meningitis were included in this study who were treated in Atatürk University Medical School Pediatrics Clinic between January 1991-1994. The mean age of the patients was 55.5± 31.7 months and 68.4% were females. The symptoms were fever(89.5%), vomiting(57.9%)and lethargy (42.1%). Family history was positive in eight cases (42.1%) and tuberculin skin test was positive in four cases (10.5%). The mean cerebrospinal fluid protein (CSF) level was 160mg/dl, CSF/serum glucose ratio was 30.8% and CSF leucocyte count was 148/mm. Chest radiographs were positive in 11 cases (57.9%). Twelve patients had computerized cranial tomography and hydrocephalus was demonstrated in seven (58.3%) of these patients. Adenosine deaminase activity was determined in six cases and all were high (33.4 ±4.7 U/L). The diagnosis of tuberculous menengitis was confirmed by polymerase chain reaction in four cases. Mycobacterium tuberculosis culture was positive in five of the nineteen cases. At admission two (10.5 %) cases were in Stage I, eight (42.1%) were in Stage II, and nine (47.4%) were in Stage III. Mortality ratio was 47.4% and it was highest in Stage III.
Açıklama
Anahtar Kelimeler
Tüberküloz menenjit, Klinik bulgular, Mortalite
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
3
Sayı
1
Künye
Energin, V. Meltem.,Orbak, Z.,Alp, H.,Akdağ, R.,Selimoğlu, M. Ayşe.,(1996). Tüberküloz menenjitli 19 çocuk olgunun değerlendirilmesi.Turgut Özal Tıp Merkezi Dergisi, 3 (1).26-29 ss.
