caa a22 4500 445807180 CHVBK 20180317145200.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00415-010-5744-8 doi (NATIONALLICENCE)springer-10.1007/s00415-010-5744-8 Tuberculous meningitis in patients infected with human immunodeficiency virus [Elektronische Daten] [Ravindra Garg, Manish Sinha] Tuberculosis is the most common opportunistic infection in human immunodeficiency virus (HIV) infected persons. HIV-infected patients have a high incidence of tuberculous meningitis as well. The exact incidence and prevalence of tuberculous meningitis in HIV-infected patients are not known. HIV infection does not significantly alter the clinical manifestations, laboratory, radiographic findings, or the response to therapy. Still, some differences have been noted. For example, the histopathological examination of exudates in HIV-infected patients shows fewer lymphocytes, epithelioid cells, and Langhan's type of giant cells. Larger numbers of acid-fast bacilli may be seen in the cerebral parenchyma and meninges. The chest radiograph is abnormal in up to 46% of patients with tuberculous meningitis. Tuberculous meningitis is likely to present with cerebral infarcts and mass lesions. Cryptococcal meningitis is important in differential diagnosis. The recommended duration of treatment in HIV-infected patients is 9-12months. The benefit of adjunctive corticosteroids is uncertain. Antiretroviral therapy and antituberculosis treatment should be initiated at the same time, regardless of CD4 cell counts. Tuberculous meningitis may be a manifestation of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome. Some studies have demonstrated a significant impact of HIV co-infection on mortality from tuberculous meningitis. HIV-infected patients with multidrug-resistant tuberculous meningitis have significantly higher mortality. The best way to prevent HIV-associated tuberculous meningitis is to diagnose and isolate infectious cases of tuberculosis promptly and administer appropriate treatment. Springer-Verlag, 2010 BCG vaccination nationallicence Extrapulmonary tuberculosis nationallicence Human immunodeficiency virus nationallicence Dexamethasone nationallicence Mycobacterium tuberculosis nationallicence Garg Ravindra Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, 226003, Lucknow, Uttar Pradesh, India aut Sinha Manish Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, 226003, Lucknow, Uttar Pradesh, India aut Journal of Neurology Springer-Verlag 258/1(2011-01-01), 3-13 0340-5354 258:1<3 2011 258 415 https://doi.org/10.1007/s00415-010-5744-8 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00415-010-5744-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Garg Ravindra Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, 226003, Lucknow, Uttar Pradesh, India aut NATIONALLICENCE 700 1- Sinha Manish Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, 226003, Lucknow, Uttar Pradesh, India aut NATIONALLICENCE 773 0- Journal of Neurology Springer-Verlag 258/1(2011-01-01), 3-13 0340-5354 258:1<3 2011 258 415 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer