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Tuberculous Meningitis in Which Inflammation Cannot Be Adequately Suppressed by Standard Therapy: Treatment-Resistant Tuberculous Meningitis Motohiro Yukitake 1 1Neurology, Kouhoukai Takagi Hospital Keyword: 結核性髄膜炎 , 初期悪化 , 薬剤耐性 , 脳結核腫 , HIV , tuberculous meningitis , paradoxical reaction , drug-resistance , cerebral tuberculoma pp.421-426
Published Date 2022/5/1
DOI https://doi.org/10.11477/mf.1416202059
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Abstract

To understand tuberculous meningitis (TBM), its clinical features and standard therapy were briefly reviewed. In addition, to determine the therapeutic strategies for treatment-resistant TBM, several clinical cases, including those with paradoxical reaction, ventriculitis, cerebral tuberculoma, and human immunodeficiency virus (HIV) co-infection, are presented. Steroid pulse therapy and intrathecal isoniazid administration are discussed as specific therapeutic strategies. Immune reconstitution inflammatory syndrome in patients with TBM suffering from HIV co-infection and alternative drug selection for drug-resistant TBM cases are also introduced. Although TMB is a rare central nervous system infection, it remains a serious disease with high rates of mortality and neurological sequelae. Knowing therapeutic strategies for treatment-resistant TBM is necessary to prevent a devastating prognosis.


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電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院

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