Skip to main content
Log in

Intracranial tuberculosis in the Netherlands: Four paediatric cases

  • Infectious Diseases
  • Original Paper
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Abstract

Since 1987 a resurgence of tuberculosis is occurring in the Netherlands in analogy to the situation in other industrialised countries. So far this has not been associated with an increased incidence of tuberculous meningitis, which is still a rare complication of the disease. Four cases of intracranial tuberculosis were recently diagnosed in our hospital. All children were from middle-class Dutch families with no identified risk for tuberculosis. An extensive contact identification search could identify a contact in two patients. Two children were in an advanced stage of disease before diagnosis. Skin tests were repeatedly negative in all cases which delayed treatment in two cases for almost 2 weeks. One patient developing a cerebral tuberculous focus during therapy responded well to a second course of corticosteroids. Three children developed severe neurological sequelae.

Conclusion

This report illustrates that suspicion of intracranial tuberculosis is warranted in the case of an ill-defined inflammatory neurological syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

AFB :

acid-fast bacillus

PCR :

polymerase chain reaction

PPD :

purified protein derivate

TBM :

tuberculous meningitis

References

  1. American Academy of Pediatrics Committee on Infectious diseases (1992) Chemotherapy for tuberculosis in infants and children. Pediatrics 89: 161–165

    Google Scholar 

  2. Barazzone C, Hofer M, Nussle D, Suter S, Rochat T (1993) Childhood tubereulosis at a Swiss university hospital: a 2-year study. Eur J Pediatr 152: 805–809

    PubMed  Google Scholar 

  3. Bhargava S, Gupta AK, Tandon PN (1982) Tuberculous meningitis-a CT study. Br J Radiol 55: 189–196

    PubMed  Google Scholar 

  4. Bommel EFH, Stiegelis WF, Schermers HP (1991) Paradoxal response of intracranial tuberculomas during chemotherapy: an immunologic phenomenon. Neth J Med 38: 126–130

    PubMed  Google Scholar 

  5. Broekmans JF, Klingeren B van (1993) Multiresistente tuberculose: een gevaar voor de volksgezondheid? Ned Tijdschr Geneeskd 137: 636–639

    PubMed  Google Scholar 

  6. Daniel TM (1987) New approaches to the rapid diagnosis of tuberculous meningitis. J Infect Dis 155: 599–602

    PubMed  Google Scholar 

  7. Davies PDO (1993) Tuberculosis increasing in England and Wales. BMJ 307: 63

    Google Scholar 

  8. Dole M, Maniar P, Lahiri K, Shah MD (1989) Enzyme-linked immuno-assay for the detection of mycobacterium tuberculosis specific IgG antibody in the cerebrospinal fluid in cases of tuberculous meningitis. J Trop Pediatr 35: 218–220

    PubMed  Google Scholar 

  9. Humphries MJ, Teoh R, Lau J, Gabriel M (1990) Factors of prognostic significance in Chinese children with tuberculous meningitis. Tubercle 71: 161–168

    PubMed  Google Scholar 

  10. Irdriss ZH, Sinno AA, Kronfol NM (1976) Tuberculous meningitis in childhood forty-three cases. Am J Dis Child 130: 364–367

    PubMed  Google Scholar 

  11. Kadival GV, Mazarelo TBMS, Chaparas SD (1986) Sensitivity and specificity of enzyme-linked immunosorbent assay in the detection of antigen in tuberculous meningitis in cerebrospinal fluids. J Clin Microbiol 23: 901–904

    PubMed  Google Scholar 

  12. Kaneko K, Onodera O, Miyatake T, Tsuji S (1993) Rapid diagnosis of tuberculous meningitis by polymerase chain reaction (PCR). Neurology 40: 1617–1618

    Google Scholar 

  13. Kennedy DH, Fallon RJ (1993) Tuberculous meningitis. JAMA 241: 264–268

    Google Scholar 

  14. Kent SJ, Crowe SM, Yung A, Ron Lucas C, Mijch AM (1993) Tuberculous meningitis: a 30-year Review. Clin Infect Dis 17: 987–994

    PubMed  Google Scholar 

  15. Kingsley DP, Hendrickse WA, Kendall BE, Swash M, Singh V (1987) Tuberculous meningitis: role of CT in management and prognosis. J Neurol Neurosurg Psychiatry 50: 30–36

    PubMed  Google Scholar 

  16. Molavi A, LeFrock JL (1985) Tuberculous meningitis. Med Clin North Am 69: 315–331

    PubMed  Google Scholar 

  17. Radhakrishnan VV, Mathai A (1991) Detection of mycobacterium antigen 5 in cerebrospinal fluid by inhibition ELISA and its diagnostic potential in tuberculous meningitis. J Infect Dis 163: 650–652

    PubMed  Google Scholar 

  18. Shankar P, Manjunath N, Mohan KK, Prasad K, Behari M, Shriniwas Ahuja GK (1991) Rapid diagnosis of tuberculous meningitis by polymerase chain reaction. Lancet 337: 5–7

    PubMed  Google Scholar 

  19. Starke JR, Jacobs RF, Jereb J (1992) Resurgence of tuberculosis in children. J Pediatr 120: 839–853

    PubMed  Google Scholar 

  20. Sumaya CV, Simek M, Smith MHD, Seidemann MF, Ferriss GS, Rubin W (1975) Tuberculous meningitis in children during the isoniazid era. J Pediatr 87: 43–49

    PubMed  Google Scholar 

  21. Waecker NJ, Connor JD (1990) Central nervous system tuberculosis in children: a review of 30 cases. Pediatr Infect Dis J 9: 539–543

    PubMed  Google Scholar 

  22. Yuk-Fong Liu P, Shi Z, Lau Y, Hu B (1994) Rapid diagnosis of tuberculous meningitis by a simplified nested amplification protocol. Neurology 44: 1161–1164

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Woensel, J.B.M., Hoogeveen, C.G., Begeer, J.H. et al. Intracranial tuberculosis in the Netherlands: Four paediatric cases. Eur J Pediatr 154, 546–550 (1995). https://doi.org/10.1007/BF02074832

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02074832

Key words

Navigation