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CNS Tuberculosis and Other Mycobacterial Infections

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Abstract

Tuberculous meningitis is the most severe form of tuberculous infection (Mycobacterium tuberculosis) and presents as a subacute syndrome with lymphocytic pleocytosis and low glucose in the cerebrospinal fluid (CSF) and meningeal enhancement of the basal cisterns and hydrocephalus on neuroimaging.

Diagnosis is challenging, since CSF cultures take long and are positive in less than two-thirds of patients. Empirical therapy is thus often employed. Mortality rate of this infection remains at approximately 25% of the patients.

Parenchymal involvement (tuberculomas and spinal cord damage) may also appear.

Nontuberculous mycobacteria affect AIDS patients. M. avium complex is most frequently implicated. CNS infection is rare and occurs with disseminated disease. Diagnosis is made by culture of involved tissues, and therapy requires a prolonged, multidrug regimen.

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References

  1. Kaufmann SH. Robert Koch, the Nobel Prize, and the ongoing threat of tuberculosis. N Engl J Med. 2005;353(23):2423–6.

    Article  CAS  PubMed  Google Scholar 

  2. Rieder HL, Snider DE Jr, Cauthen GM. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis. 1990;141(2):347–51.

    Article  CAS  PubMed  Google Scholar 

  3. Gupta RK, Kohli A, Gaur V, Lal JH, Kishore J. MRI of the brain in patients with miliary pulmonary tuberculosis without symptoms or signs of central nervous system involvement. Neuroradiology. 1997;39(10):699–704.

    Article  CAS  PubMed  Google Scholar 

  4. Garcia-Monco JC. Central nervous system tuberculosis. Neurol Clin. 1999;17(4):737–59.

    Article  CAS  PubMed  Google Scholar 

  5. Illingworth RS. The early diagnosis of tuberculous meningitis. Br Med J. 1950;1:479–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. STREPTOMYCIN treatment of tuberculous meningitis. Lancet. 1948;1(6503):582–96.

    Google Scholar 

  7. Verdon R, Chevret S, Laissy JP, Wolff M. Tuberculous meningitis in adults: review of 48 cases. Clin Infect Dis. 1996;22(6):982–8.

    Article  CAS  PubMed  Google Scholar 

  8. Pinto VL Jr, Lima MA, Boia MN. Persistent neutrophilic meningitis. J Neurol Neurosurg Psychiatry. 2009;80(6):697–8.

    Article  PubMed  Google Scholar 

  9. Sanchez-Portocarrero J, Perez-Cecilia E, Jimenez-Escrig A, Martin-Rabadán P, Roca V, Ruiz Yague M, et al. Tuberculous meningitis. Clinical characteristics and comparison with cryptococcal meningitis in patients with human immunodeficiency virus infection. Arch Neurol. 1996;53(7):671–6.

    Article  CAS  PubMed  Google Scholar 

  10. Garcia-Monco JC, Ferreira E, Gomez-Beldarrain M. The therapeutic paradox in the diagnosis of tuberculous meningitis. Neurology. 2005;65(12):1991–2.

    Article  PubMed  Google Scholar 

  11. Ogawa SK, Smith MA, Brennessel DJ, Lowy FD. Tuberculous meningitis in an urban medical center. Medicine (Baltimore). 1987;66(4):317–26.

    Article  CAS  Google Scholar 

  12. Barret-Connor E. Tuberculous meningitis in adults. South Med J. 1967;60:1060–7.

    Article  Google Scholar 

  13. Moghtaderi A, Alavi-Naini R, Izadi S, Cuevas LE. Diagnostic risk factors to differentiate tuberculous and acute bacterial meningitis. Scand J Infect Dis. 2009;41(3):188–94.

    Article  PubMed  Google Scholar 

  14. Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J. Tuberculous meningitis. J Neurol Neurosurg Psychiatry. 2000;68(3):289–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Chen P, Shi M, Feng GD, Liu JY, Wang BJ, Shi XD, et al. A highly efficient Ziehl-Neelsen stain: identifying de novo intracellular Mycobacterium tuberculosis and improving detection of extracellular M. tuberculosis in cerebrospinal fluid. J Clin Microbiol. 2012;50(4):1166–70.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Thwaites GE. Advances in the diagnosis and treatment of tuberculous meningitis. Curr Opin Neurol. 2013;26(3):295–300.

    Article  CAS  PubMed  Google Scholar 

  17. Metcalfe JZ, Everett CK, Steingart KR, Cattamanchi A, Huang L, Hopewell PC, et al. Interferon-gamma release assays for active pulmonary tuberculosis diagnosis in adults in low- and middle-income countries: systematic review and meta-analysis. J Infect Dis. 2011;204(Suppl 4):S1120–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Yu J, Wang ZJ, Chen LH, Li HH. Diagnostic accuracy of interferon-gamma release assays for tuberculous meningitis: a meta-analysis. Int J Tuberc Lung Dis. 2016;20(4):494–9.

    Article  CAS  PubMed  Google Scholar 

  19. Watterson SA, Drobniewski FA. Modern laboratory diagnosis of mycobacterial infections. J Clin Pathol. 2000;53(10):727–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Ho J, Marais BJ, Gilbert GL, Ralph AP. Diagnosing tuberculous meningitis—have we made any progress? Tropical Med Int Health. 2013;18(6):783–93.

    Article  Google Scholar 

  21. Malan C, Donald PR, Golden M, Taljaard JJ. Adenosine deaminase levels in cerebrospinal fluid in the diagnosis of tuberculous meningitis. J Trop Med Hyg. 1984;87(1):33–40.

    CAS  PubMed  Google Scholar 

  22. Mishra OP, Loiwal V, Ali Z, Nath G, Chandra L. Cerebrospinal fluid adenosine deaminase activity for the diagnosis of tuberculous meningitis in children. J Trop Pediatr. 1996;42(3):129–32.

    Article  CAS  PubMed  Google Scholar 

  23. Pettersson T, Klockars M, Weber TH, Somer H. Diagnostic value of cerebrospinal fluid adenosine deaminase determination. Scand J Infect Dis. 1991;23(1):97–100.

    Article  CAS  PubMed  Google Scholar 

  24. Garcia-Monco C, Berciano J. Sarcoid meningitis, high adenosine deaminase levels in CSF and results of cranial irradiation. J Neurol Neurosurg Psychiatry. 1988;51(12):1594–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Ribera E, Martinez-Vazquez JM, Ocana I, Segura RM, Pascual C. Activity of adenosine deaminase in cerebrospinal fluid for the diagnosis and follow-up of tuberculous meningitis in adults. J Infect Dis. 1987;155(4):603–7.

    Article  CAS  PubMed  Google Scholar 

  26. Ribera E, Martinez-Vazquez JM, Ocana I. New diagnostic methods in meningeal tuberculosis. Med Clin (Barc). 1987;89(11):479–82.

    CAS  Google Scholar 

  27. Tuon FF, Higashino HR, Lopes MI, Litvoc MN, Atomiya AN, Antonangelo L, et al. Adenosine deaminase and tuberculous meningitis—a systematic review with meta-analysis. Scand J Infect Dis. 2010;42(3):198–207.

    Article  CAS  PubMed  Google Scholar 

  28. Cole ST, Brosch R, Parkhill J, Garnier T, Churcher C, Harris D, et al. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature. 1998;393(6685):537–44.

    Article  CAS  PubMed  Google Scholar 

  29. Pai M, Flores LL, Pai N, Hubbard A, Riley LW, Colford JM Jr. Diagnostic accuracy of nucleic acid amplification tests for tuberculous meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2003;3(10):633–43.

    Article  CAS  PubMed  Google Scholar 

  30. Haldar S, Sankhyan N, Sharma N, Bansal A, Jain V, Gupta VK, et al. Detection of Mycobacterium tuberculosis GlcB or HspX antigens or devR DNA impacts the rapid diagnosis of tuberculous meningitis in children. PLoS One. 2012;7(9):e44630.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ozates M, Kemaloglu S, Gurkan F, Ozkan U, Hoşoglu S, Simşek MM. CT of the brain in tuberculous meningitis. A review of 289 patients. Acta Radiol. 2000;41(1):13–7.

    Article  CAS  PubMed  Google Scholar 

  32. Berenguer J, Moreno S, Laguna F, Vicente T, Adrados M, Ortega A. Tuberculous meningitis in patients infected with the human immunodeficiency virus. N Engl J Med. 1992;326(10):668–72.

    Article  CAS  PubMed  Google Scholar 

  33. Belorgey L, Lalani I, Zakaria A. Ischemic stroke in the setting of tuberculous meningitis. J Neuroimaging. 2006;16(4):364–6.

    Article  PubMed  Google Scholar 

  34. Alarcon F, Escalante L, Perez Y, Banda H, Chacon G, Duenas G. Tuberculous meningitis. Short course of chemotherapy [published erratum appears in Arch Neurol 1991 Sep;48(9):920]. Arch Neurol. 1990;47(12):1313–7.

    Article  CAS  PubMed  Google Scholar 

  35. Leiguarda R, Berthier M, Starkstein S, Nogués M, Lylyk P. Ischemic infarction in 25 children with tuberculous meningitis. Stroke. 1988;19(2):200–4.

    Article  CAS  PubMed  Google Scholar 

  36. Daif AK, al Rajeh S, Ogunniyi A, al Boukai A, al Tahan A. Syringomyelia developing as an acute complication of tuberculous meningitis. Can J Neurol Sci. 1997;24(1):73–6.

    Article  CAS  PubMed  Google Scholar 

  37. Bass JB Jr, Farer LS, Hopewell PC, O'Brien R, Jacobs RF, Ruben F, et al. Treatment of tuberculosis and tuberculosis infection in adults and children. American Thoracic Society and the Centers for Disease Control and Prevention. Am J Respir Crit Care Med. 1994;149(5):1359–74.

    Article  PubMed  Google Scholar 

  38. Horsburgh CR Jr, Feldman S, Ridzon R. Practice guidelines for the treatment of tuberculosis. Clin Infect Dis. 2000;31(3):633–9.

    Article  PubMed  Google Scholar 

  39. Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J, et al. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect. 2009;59(3):167–87.

    Article  PubMed  Google Scholar 

  40. Small PM, Fujiwara PI. Management of tuberculosis in the United States. N Engl J Med. 2001;345(3):189–200.

    Article  CAS  PubMed  Google Scholar 

  41. van Loenhout-Rooyackers JH, Keyser A, Laheij RJ, Verbeek AL, van der Meer JW. Tuberculous meningitis: is a 6-month treatment regimen sufficient? Int J Tuberc Lung Dis. 2001;5(11):1028–35.

    PubMed  Google Scholar 

  42. Dutt AK, Moers D, Stead WW. Short-course chemotherapy for extrapulmonary tuberculosis. Nine years’ experience. Ann Intern Med. 1986;104(1):7–12.

    Article  CAS  PubMed  Google Scholar 

  43. Donald PR, Schoeman JF, Van Zyl LE, De Villiers JN, Pretorius M, Springer P. Intensive short course chemotherapy in the management of tuberculous meningitis. Int J Tuberc Lung Dis. 1998;2(9):704–11.

    CAS  PubMed  Google Scholar 

  44. Ruslami R, Ganiem AR, Dian S, Apriani L, Achmad TH, van der Ven AJ, et al. Intensified regimen containing rifampicin and moxifloxacin for tuberculous meningitis: an open-label, randomised controlled phase 2 trial. Lancet Infect Dis. 2013;13(1):27–35.

    Article  PubMed  Google Scholar 

  45. Heemskerk D, Day J, Chau TT, Dung NH, Yen NT, Bang ND, et al. Intensified treatment with high dose rifampicin and levofloxacin compared to standard treatment for adult patients with tuberculous meningitis (TBM-IT): protocol for a randomized controlled trial. Trials. 2011;12:25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Dooley DP, Carpenter JL, Rademacher S. Adjunctive corticosteroid therapy for tuberculosis: a critical reappraisal of the literature. Clin Infect Dis. 1997;25(4):872–87.

    Article  CAS  PubMed  Google Scholar 

  47. Schoeman JF, Van Zyl LE, Laubscher JA, Donald PR. Effect of corticosteroids on intracranial pressure, computed tomographic findings, and clinical outcome in young children with tuberculous meningitis. Pediatrics. 1997;99(2):226–31.

    Article  CAS  PubMed  Google Scholar 

  48. Thwaites GE, Nguyen DB, Nguyen HD, Hoang TQ, Do TT, Nguyen TC, et al. Dexamethasone for the treatment of tuberculous meningitis in adolescents and adults. N Engl J Med. 2004;351(17):1741–51.

    Article  CAS  PubMed  Google Scholar 

  49. Fortun J, Gomez-Mampaso E, Navas E, Hermida JM, Antela A, Guerrero A. Tuberculous meningitis caused by resistant microorganisms. Therapeutic failure in 2 patients with HIV infection and disseminated tuberculosis. Enferm Infecc Microbiol Clin. 1994;12(3):150–3.

    CAS  PubMed  Google Scholar 

  50. Horn DL, Hewlett D Jr, Peterson S, Sabido D, Opal SM. RISE-resistant tuberculous meningitis in AIDS patient. Lancet. 1993;341(8838):177–8.

    Article  CAS  PubMed  Google Scholar 

  51. Steiner P, Rao M, Victoria MS, Hunt J, Steiner M. A continuing study of primary drug-resistant tuberculosis among children observed at the Kings County Hospital Medical Center between the years 1961 and 1980. Am Rev Respir Dis. 1983;128(3):425–8.

    Article  CAS  PubMed  Google Scholar 

  52. Berning SE. The role of fluoroquinolones in tuberculosis today. Drugs. 2001;61(1):9–18.

    Article  CAS  PubMed  Google Scholar 

  53. WHO Guidelines Approved by the Guidelines Review Committee. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children: policy update. Geneva: World Health Organization; 2013.

    Google Scholar 

  54. Sheu JJ, Yuan RY, Yang CC. Predictors for outcome and treatment delay in patients with tuberculous meningitis. Am J Med Sci. 2009;338(2):134–9.

    Article  PubMed  Google Scholar 

  55. Kalita J, Misra UK. Motor and somatosensory evoked potentials in tuberculous meningitis: a clinico-radiological correlation. Acta Neurol Scand. 1999;99(4):225–31.

    Article  CAS  PubMed  Google Scholar 

  56. Dastur DK, Lalitha VS, Prabhakar V. Pathological analysis of intracranial space-occupying lesions in 1000 cases including children. 1. Age, sex and pattern; and the tuberculomas. J Neurol Sci. 1968;6(3):575–92.

    Article  CAS  PubMed  Google Scholar 

  57. Jinkins JR. Computed tomography of intracranial tuberculosis. Neuroradiology. 1991;33(2):126–35.

    Article  CAS  PubMed  Google Scholar 

  58. Man H, Sellier P, Boukobza M, Clevenbergh P, Diemer M, Raskine L. Central nervous system tuberculomas in 23 patients. Scand J Infect Dis. 2010;42(6–7):450–4.

    Article  CAS  PubMed  Google Scholar 

  59. Mayers MM, Kaufman DM, Miller MH. Recent cases of intracranial tuberculomas. Neurology. 1978;28(3):256–60.

    Article  CAS  PubMed  Google Scholar 

  60. Whiteman ML. Neuroimaging of central nervous system tuberculosis in HIV-infected patients. Neuroimaging Clin N Am. 1997;7(2):199–214.

    CAS  PubMed  Google Scholar 

  61. Kong A, Koukourou A, Boyd M, Crowe G. Metastatic adenocarcinoma mimicking ‘target sign’ of cerebral tuberculosis. J Clin Neurosci. 2006;13(9):955–8.

    Article  PubMed  Google Scholar 

  62. Gupta RK, Jena A, Singh AK, Sharma A, Puri V, Gupta M. Role of magnetic resonance (MR) in the diagnosis and management of intracranial tuberculomas. Clin Radiol. 1990;41(2):120–7.

    Article  CAS  PubMed  Google Scholar 

  63. Basoglu OK, Savas R, Kitis O. Conventional and diffusion-weighted MR imaging of intracranial tuberculomas. A case report. Acta Radiol. 2002;43(6):560–2.

    Article  PubMed  Google Scholar 

  64. Pui MH, Ahmad MN. Magnetization transfer imaging diagnosis of intracranial tuberculomas. Neuroradiology. 2002;44(3):210–5.

    Article  CAS  PubMed  Google Scholar 

  65. DeAngelis LM. Intracranial tuberculoma: case report and review of the literature. Neurology. 1981;31(9):1133–6.

    Article  CAS  PubMed  Google Scholar 

  66. Garcia-Monco JC, Gomez Beldarrain M, Fernandez Canton G, Capelastegui A, Collazos J. Resolution of a brainstem abscess through antituberculous therapy. Neurology. 1997;49(1):265–7.

    Article  CAS  PubMed  Google Scholar 

  67. Arseni C. Two hundred and one cases of intracranial tuberculoma treated surgically. J Neurol Neurosurg Psychiatry. 1958;21:308–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Afghani B, Lieberman JM. Paradoxical enlargement or development of intracranial tuberculomas during therapy: case report and review. Clin Infect Dis. 1994;19(6):1092–9.

    Article  CAS  PubMed  Google Scholar 

  69. Cheng VC, Ho PL, Lee RA, Chan KS, Chan KK, Woo PC, et al. Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. Eur J Clin Microbiol Infect Dis. 2002;21(11):803–9.

    Article  CAS  PubMed  Google Scholar 

  70. Hejazi N, Hassler W. Multiple intracranial tuberculomas with atypical response to tuberculostatic chemotherapy: literature review and a case report. Acta Neurochir. 1997;139(3):194–202.

    Article  CAS  PubMed  Google Scholar 

  71. Tyson G, Newman P, Strachan WE. Tuberculous brain abscess. Surg Neurol. 1978;10(5):323–5.

    CAS  PubMed  Google Scholar 

  72. Kumar R, Pandey CK, Bose N, Sahay S. Tuberculous brain abscess: clinical presentation, pathophysiology and treatment (in children). Childs Nerv Syst. 2002;18(3–4):118–23.

    Article  PubMed  Google Scholar 

  73. Sermet-Gaudelus I, Stambouli F, Abadie V, Goutières F, Lenoir G, Gendrel D, et al. Rapid improvement of intracranial tuberculomas after addition of ofloxacin to first-line antituberculosis treatment. Eur J Clin Microbiol Infect Dis. 1999;18(10):726–8.

    Article  CAS  PubMed  Google Scholar 

  74. Kocen RS, Parsons M. Neurological complications of tuberculosis: some unusual manifestations. Q J Med. 1970;39(153):17–30.

    CAS  PubMed  Google Scholar 

  75. Dastur D, Wadia NH. Spinal meningitides with radiculo-myelopathy. 2. Pathology and pathogenesis. J Neurol Sci. 1969;8(2):261–97.

    Article  CAS  PubMed  Google Scholar 

  76. Gupta RK, Gupta S, Kumar S, Kohli A, Misra UK, Gujral RB. MRI in intraspinal tuberculosis. Neuroradiology. 1994;36(1):39–43.

    Article  CAS  PubMed  Google Scholar 

  77. de La Blanchardiere A, Stern JB, Molina JM, Lesprit P, Gasnault J, de Kerviler E, et al. Spinal tuberculous arachnoiditis. Presse Med. 1996;25(29):1333–5.

    Google Scholar 

  78. Lu M. Imaging diagnosis of spinal intramedullary tuberculoma: case reports and literature review. J Spinal Cord Med. 2010;33(2):159–62.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Hanci M, Sarioglu AC, Uzan M, Işlak C, Kaynar MY, Oz B. Intramedullary tuberculous abscess: a case report. Spine. 1996;21(6):766–9.

    Article  CAS  PubMed  Google Scholar 

  80. Modic MT, Feiglin DH, Piraino DW, Boumphrey F, Weinstein MA, Duchesneau PM, et al. Vertebral osteomyelitis: assessment using MR. Radiology. 1985;157(1):157–66.

    Article  CAS  PubMed  Google Scholar 

  81. Thwaites GE, Duc Bang N, Huy Dung N, Thi Quy H, Thi Tuong Oanh D, Thi Cam Thoa N, et al. The influence of HIV infection on clinical presentation, response to treatment, and outcome in adults with Tuberculous meningitis. J Infect Dis. 2005;192(12):2134–41.

    Article  PubMed  Google Scholar 

  82. Whiteman M, Espinoza L, Post MJ, Bell MD, Falcone S. Central nervous system tuberculosis in HIV-infected patients: clinical and radiographic findings. AJNR Am J Neuroradiol. 1995;16(6):1319–27.

    CAS  PubMed  Google Scholar 

  83. Wallace RJ. Antimycobacterial agents. In: Mandell GI, Bennet JE, Dolin R, editors. Principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2000. p. 436–48.

    Google Scholar 

  84. Gordon SM, Horsburgh CR Jr, Peloquin CA, Havlik JA Jr, Metchock B, Heifets L, et al. Low serum levels of oral antimycobacterial agents in patients with disseminated Mycobacterium avium complex disease. J Infect Dis. 1993;168(6):1559–62.

    Article  CAS  PubMed  Google Scholar 

  85. Rao GP, Nadh BR, Hemaratnan A, Srinivas TV, Reddy PK. Paradoxical progression of tuberculous lesions during chemotherapy of central nervous system tuberculosis. J Neurosurg. 1995;83:359–62.

    Article  CAS  PubMed  Google Scholar 

  86. Anonymous. Prevention and treatment of tuberculosis among patients infected with human immunodeficiency virus: principles of therapy and revised recommendations. Centers for Disease Control and Prevention. MMWR Morb Mortal Wkly Rep. 1998;47(RR-20):1–58.

    Google Scholar 

  87. Marais S, Scholtz P, Pepper DJ, Meintjes G, Wilkinson RJ, Candy S. Neuroradiological features of the tuberculosis-associated immune reconstitution inflammatory syndrome. Int J Tuberc Lung Dis. 2010;14(2):188–96.

    CAS  PubMed  PubMed Central  Google Scholar 

  88. Brown BA, Wallace RJ Jr. Infections due to nontuberculous mycobacteria. In: Mandell GI, Bennet JE, Dolin R, editors. Principles and practice of infectious disease. Philadelphia: Churchill Livingstone; 2000. p. 2630–6.

    Google Scholar 

  89. Brown-Elliott BA, Griffith DE, Wallace RJ Jr. Diagnosis of nontuberculous mycobacterial infections. Clin Lab Med. 2002;22(4):911–25.

    Article  PubMed  Google Scholar 

  90. Cook VJ, Turenne CY, Wolfe J, Pauls R, Kabani A. Conventional methods versus 16S ribosomal DNA sequencing for identification of nontuberculous mycobacteria: cost analysis. J Clin Microbiol. 2003;41(3):1010–5.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Flor A, Capdevila JA, Martin N, Gavaldà J, Pahissa A. Nontuberculous mycobacterial meningitis: report of two cases and review. Clin Infect Dis. 1996;23(6):1266–73.

    Article  CAS  PubMed  Google Scholar 

  92. Jacob CN, Henein SS, Heurich AE, Kamholz S. Nontuberculous mycobacterial infection of the central nervous system in patients with AIDS. South Med J. 1993;86(6):638–40.

    Article  CAS  PubMed  Google Scholar 

  93. Weiss IK, Krogstad PA, Botero C, Von Seidlein L, Nash K. Fatal Mycobacterium avium meningitis after mis-identification of M tuberculosis. Lancet. 1995;345(8955):991–2.

    Article  CAS  PubMed  Google Scholar 

  94. Berman SM, Kim RC, Haghighat D, Mulligan ME, Fierer J, Wyle FC. Mycobacterium genavense infection presenting as a solitary brain mass in a patient with AIDS: case report and review. Clin Infect Dis. 1994;19(6):1152–4.

    Article  CAS  PubMed  Google Scholar 

  95. Duong M, Piroth L, Chavanet P, Combernoux A, Grappin M, Portier H. A case of rhombencephalitis with isolation of cytomegalovirus and Mycobacterium avium complex in a woman with AIDS. AIDS. 1994;8(9):1356–7.

    Article  CAS  PubMed  Google Scholar 

  96. Uldry PA, Bogousslavsky J, Regli F, Chave JP, Beer V. Chronic Mycobacterium avium complex infection of the central nervous system in a nonimmunosuppressed woman. Eur Neurol. 1992;32(5):285–8.

    Article  CAS  PubMed  Google Scholar 

  97. Gyure KA, Prayson RA, Estes ML, Hall GS. Symptomatic Mycobacterium avium complex infection of the central nervous system. A case report and review of the literature. Arch Pathol Lab Med. 1995;119(9):836–9.

    CAS  PubMed  Google Scholar 

  98. Landgraf IM, Palaci M, Vieira MF, Ueki SY, Martins MC, Sato DN, et al. Bacterial agents isolated from cerebrospinal fluid of patients with acquired immunodeficiency syndrome (AIDS) and neurological complications. Rev Inst Med Trop Sao Paulo. 1994;36(6):491–6.

    Article  CAS  PubMed  Google Scholar 

  99. Hadad DJ, Petry TC, Maresca AF, Ferrazoli L, Martins MC, Palhares MC, et al. Mycobacterium avium complex (MAC): an unusual potential pathogen in cerebrospinal fluid of AIDS patients. Rev Inst Med Trop Sao Paulo. 1995;37(2):93–8.

    Article  CAS  PubMed  Google Scholar 

  100. Norton GR, Sweeney J, Marriott D, Law MG, Brew BJ. Association between HIV distal symmetric polyneuropathy and Mycobacterium avium complex infection. J Neurol Neurosurg Psychiatry. 1996;61(6):606–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  101. el-Zaatari FA, Graham DY, Samuelsson K, Engstrand L. Detection of Mycobacterium avium complex in cerebrospinal fluid of a sarcoid patient by specific polymerase chain reaction assays. Scand J Infect Dis. 1997;29(2):202–4.

    Article  CAS  PubMed  Google Scholar 

  102. Diagnosis and treatment of disease caused by nontuberculous mycobacteria. This official statement of the American Thoracic Society was approved by the Board of Directors, March 1997. Medical Section of The American Lung Association. Am J Respir Crit Care Med. 1997;156(2 Pt 2):S1–25.

    Google Scholar 

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García-Moncó, J.C., Rodriguez-Sainz, A. (2018). CNS Tuberculosis and Other Mycobacterial Infections. In: García-Moncó, J. (eds) CNS Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-70296-4_8

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