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
Citations
Cites
Global tuberculosis control 2010
Behera, D. (2012) · The Indian Journal of Medical Research · Cited by 1,262
Trunz, B. B., Fine, P., & Dye, C. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68507-3 · Cited by 1,114
Thwaites, G. E., Fisher, M., Hemingway, C. A., Scott, G. M., Solomon, T., & Innes, J. (2009) · Journal of Infection · doi:10.1016/j.jinf.2009.06.011 · Cited by 673
Newsom, S. W. B. (2006) · Journal of Hospital Infection · doi:10.1016/j.jhin.2006.06.003 · Cited by 636
Roca, F. J., & Ramakrishnan, L. (2013) · Cell · doi:10.1016/j.cell.2013.03.022 · Cited by 592
Host Genotype-Specific Therapies Can Optimize the Inflammatory Response to Mycobacterial Infections
Tobin, D. M., Roca, F. J., Oh, S. F., McFarland, R., Vickery, T. W., Ray, J. P., Ko, D. C., Zou, Y., Bang, N. D., Chau, T. T. H., et al. (2012) · Cell · doi:10.1016/j.cell.2011.12.023 · Cited by 583
Corticosteroids for managing tuberculous meningitis
Prasad, K., Singh, M. B., & Ryan, H. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002244.pub4 · Cited by 547
The lta4h Locus Modulates Susceptibility to Mycobacterial Infection in Zebrafish and Humans
Tobin, D. M., Vary, J. C., Ray, J. P., Walsh, G. S., Dunstan, S. J., Bang, N. D., Hagge, D. A., Khadge, S., King, M., Hawn, T. R., et al. (2010) · Cell · doi:10.1016/j.cell.2010.02.013 · Cited by 520
Lawn, S. D., & Nicol, M. P. (2011) · Future Microbiology · doi:10.2217/fmb.11.84 · Cited by 507
Caws, M., Thwaites, G. E., Dunstan, S. J., Hawn, T. R., Lan, N. T. N., Thương, N. T. T., Stepniewska, K., Huyen, M. N. T., Bang, N. D., Loc, T. H., et al. (2008) · PLoS Pathogens · doi:10.1371/journal.ppat.1000034 · Cited by 500
Cited by
Sorted by citations
Corticosteroids for managing tuberculous meningitis
Prasad, K., Singh, M. B., & Ryan, H. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002244.pub4 · Cited by 547
Brouwer, M. C., Tunkel, A. R., McKhann, G. M., & van de Beek, D. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1301635 · Cited by 537
Diagnosis and Treatment of Extrapulmonary Tuberculosis
Lee, J. Y. (2015) · Tuberculosis & respiratory diseases · doi:10.4046/trd.2015.78.2.47 · Cited by 541
Wilkinson, R. J., Rohlwink, U. K., Misra, U. K., van Crevel, R., Hoang, N. T., Dooley, K. E., Caws, M., Figaji, A., Savić, R. M., Solomons, R., et al. (2017) · Nature Reviews Neurology · doi:10.1038/nrneurol.2017.120 · Cited by 518
Extrapulmonary tuberculosis: an overview
Ramírez-Lapausa, M., Menéndez-Saldaña, A., & Noguerado-Asensio, A. (2015) · Cited by 478
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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