Prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis

• Autor(a) principal: Rodrigues, Murilo Gimenes [UNIFESP]
• Data de Publicação: 2010
• Outros Autores: Lin, Jaime [UNIFESP], Masruha, Marcelo Rodrigues [UNIFESP], Vilanova, Luiz Celso Pereira [UNIFESP], Minett, Thaís Soares Cianciarullo [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-282X2010000500015; http://repositorio.unifesp.br/handle/11600/5987
• topic: tuberculosis; meningitis; central nervous system; prognosis; child; tuberculose; meningite; sistema nervoso central; prognóstico; crianças

OBJECTIVE: To identify prognostic factors predicting a fatal outcome in HIV-negative children with neurotuberculosis based on clinical, epidemiological, and laboratory findings. METHOD: The clinical records of all in-patients diagnosed with neurotuberculosis from 1982 to 2005 were evaluated retrospectively. The following prognostic parameters were examined: gender, age, close contact with a tuberculosis-infected individual, vaccination for bacillus Calmette-Guérin, purified protein derivative (PPD) of tuberculin results, concomitant miliary tuberculosis, seizures, CSF results, and hydrocephalus. RESULTS: One hundred forty-one patients diagnosed with neurotuberculosis were included. Seventeen percent of the cases resulted in death. The factors that were correlated with a negative outcome included lack of contact with a tuberculosis-infected individual, negative PPD reaction, coma, and longer hospitalisation time. A multiple logistic regression analysis was performed to identify which of these factors most often resulted in death. CONCLUSION: Coma at diagnosis, lack of tuberculosis contact, and a non-reactive PPD were the most important predictors of fatality in patients with neurotuberculosis