The DOI matches its Crossref record; 137 of the 138 references it cites were found in a registry or an index.
Tuberculous meningitis: more questions, still too few answers
Abstract
Tuberculous meningitis is especially common in young children and people with untreated HIV infection, and it kills or disables roughly half of everyone affected. Childhood disease can be prevented by vaccination and by giving prophylactic isoniazid to children exposed to infectious adults, although improvements in worldwide tuberculosis control would lead to more effective prevention. Diagnosis is difficult because clinical features are non-specific and laboratory tests are insensitive, and treatment delay is the strongest risk factor for death. Large doses of rifampicin and fluoroquinolones might improve outcome, and the beneficial effect of adjunctive corticosteroids on survival might be augmented by aspirin and could be predicted by screening for a polymorphism in LTA4H, which encodes an enzyme involved in eicosanoid synthesis. However, these advances are insufficient in the face of drug-resistant tuberculosis and HIV co-infection. Many questions remain about the best approaches to prevent, diagnose, and treat tuberculous meningitis, and there are still too few answers.
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“Around 50% of those affected die or experience disabling consequences (Thwaites 2013).”
From Xpert MTB/RIF Ultra and Xpert MTB/RIF assays for extrapulmonary tuberculosis and rifampicin resistance in adults (2021) · cites this paper as Thwaites 2013
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Metadata
- Authors
- Thwaites, G. E., van Toorn, R., & Schoeman, J.
- Affiliations
- Guy's Hospital (GB)
- Stellenbosch University (ZA)
- Corresponding author
- Thwaites, Guy E
- ORCID
- Thwaites, Guy E
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 12
- Issue
- 10
- Pages
- 999-1010
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W2110728266
- Cited by
- 482
- References
- 138
- Citations by year
- 2026: 42 · 2025: 33 · 2024: 46 · 2023: 44 · 2022: 38 · 2021: 38 · 2020: 38 · 2019: 45 · 2018: 32 · 2017: 37 · 2016: 40 · 2015: 25 · 2014: 23 · 2013: 1
- FWCI
- 5.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- Wellcome Trust (089276)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infectious Diseases and Tuberculosis
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Keywords
- tuberculous meningitis, HIV coinfection, pediatric tuberculosis, isoniazid preventive therapy, tuberculosis vaccination, diagnosis, treatment delay, rifampicin, fluoroquinolones, adjunctive corticosteroid therapy, aspirin, drug-resistant tuberculosis, tuberculosis control
- MeSH terms
- Adult, Child, Humans, Tuberculosis, Meningeal
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