NEUROSURGICAL CARE FOR HIV-INFECTED PATIENTS WITH LOCAL FORMS OF TUBERCULOSIS OF CENTRAL NERVOUS SYSTEM
https://doi.org/10.21292/2075-1230-2016-94-11-30-37
Abstract
Goal of the study: to define the interaction procedure between phthisiologists and neurosurgeons when managing local tuberculosis of central nervous system in HIV-infected patients.
Materials and methods. Histological, mycobacteriologic and X-ray features of CNS tuberculosis were studied in 73 died and 5 operated HIV-infected patients.
Results. Stepwise treatment of the patients with local HIV-associated tuberculous lesions of brain includes conservative treatment with the search for the causative agent in all available biological liquids, and should the therapy fail then the decision is made about biopsy for diagnosis confirmation and sensitivity testing and the consequent decision about surgery aimed to remove the lesion. The surgery can be performed only after the relevant anti-bacterial treatment in compliance with drug sensitivity data till perifocal edema is not visible on the brain images.
About the Authors
O. N. Novitskaya
Irkutsk State Medical University;
Irkutsk Regional Clinical Tuberculosis Hospital
Russian Federation
Russian Federation
Head of Phthisiopulmonology Department,
1, Krasnogo Vosstaniya St., Irkutsk, 664003
S. I. Petrov
Irkutsk Regional Clinical Hospital
Russian Federation
Russian Federation
Head of Neurosurgery Department,
100, Yubileyny R.D., Irkutsk, 664079
O. V. Kanya
Regional Morbid Anatomy Bureau
Russian Federation
Russian Federation
Head,
100, Yubileyny R.D., Irkutsk, 664059
References
1. Filippova T.P., Novitskaya O.N., Bykov Yu.N., Kornilova Z.Kh. VICH-assotsiirovanny tuberkulez tsentralnoy nervnoy sistemy v regione s vysokim urovnem rasprostraneniya tuberkuleza i VICH-infektsii. [HIV-associated tuberculosis of central nervous system in the region with high prevalence of tuberculosis and HIV-infection]. Moscow, R. Valent Publ., 2012, 132 p.
2. Barr L.K., Sharer L.R., Khadka Kunwar E. et al. Intraventricular granulomatous mass associated with Mycobacterium haemophilum: A rare central nervous system manifestation in a patient with human immunodeficiency virus infection. J. Clin. Neurosci., 2015, vol. 22, no. 6, pp. 1057-1060. doi: 10.1016/j.jocn.2014.11.036. Epub 2015 Mar 25. [PubMed]
3. Bishburg E., Sunderam G., Reichman L.B., Kapila R. Central nervous system tuberculosis with the acquired immunodeficiency syndrome and its related complex. Ann. Intern. Med., 1986, vol. 105, no. 2, pp. 210-213. [PubMed]
4. Jung E.K., Chang J.Y., Lee Y.P. et al. A case of disseminated multidrug-resistant tuberculosis involving the brain. Infect. Chemother., 2016, vol. 48, no. 1, pp. 41-46. doi: 10.3947/ic.2016.48.1.41. Epub 2016 Mar 31. [PubMed]
5. Lesprit P., Zagdanski A.M., de La Blanchardière A. et al. Cerebral tuberculosis in patients with the acquired immunodeficiency syndrome (AIDS). Report of 6 cases and review. Medicine (Baltimore), 1997, vol. 76, no. 6, pp. 423. [PubMed]
6. Rajshekhar V. Surgery for brain tuberculosis: a review. Acta Neurochir (Wien), 2015, vol. 157, no. 10, pp. 1665-1678. doi: 10.1007/s00701-015-2501-x. Epub 2015 Jul 14. [PubMed]
7. Sharma M., Velho V., Kharosekar H. A rare case of an isolated intraventricular tuberculoma with a dismal outcome: an unusual location of a common pathology and lessons learnt. Indian. J. Tuberc., 2014, vol. 61, no. 2, pp. 166-170. [PubMed]
8. Takeshima H., Kawahara T., Kuratsu J. Multiple meningeal tuberculomas recurring after 18-month anti-tuberculous chemotherapy-case report. Neurol. Med. Chir. (Tokyo), 2004, vol. 44, no. 3, pp. 133-137. [PubMed]
9. Vidal J.E., Hernández A.V., Oliveira A.C. et al. Cerebral tuberculomas in AIDS patients: a forgotten diagnosis? Arq Neuropsiquiatr., 2004, vol. 62, no. 2, pp. 793-796. Epub 2004 Oct 5. [PubMed]
10. Yadegarynia D., Merza M.A., Sali S. , Seghatoleslami Z.S. Multiple intracranial tuberculomas in a post-kidney transplant patient. Saudi. J. Kidney Dis. Transpl., 2016, vol. 27, no. 1, pp. 135-138. doi: 10.4103/1319-2442.174163. [PubMed]
11. Zibly Z., Levy I., Litchevski V.et al. Brain biopsy in AIDS patients: diagnostic yield and treatment applications. AIDS Res Ther., 2014, vol. 11, no. 4, Published online 2014 Jan 21. doi: 10.1186/1742-6405-11-4. [РМС]
Review
For citations:
Novitskaya O.N., Petrov S.I., Kanya O.V. NEUROSURGICAL CARE FOR HIV-INFECTED PATIENTS WITH LOCAL FORMS OF TUBERCULOSIS OF CENTRAL NERVOUS SYSTEM. Tuberculosis and Lung Diseases. 2016;94(11):30-37. (In Russ.) https://doi.org/10.21292/2075-1230-2016-94-11-30-37
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