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

Arq Neuropsiquiatr. 2010 Oct;68(5):755-60. doi: 10.1590/s0004-282x2010000500015.

Abstract

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.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Mycobacterium tuberculosis / isolation & purification*
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Tuberculosis, Central Nervous System / diagnosis
  • Tuberculosis, Central Nervous System / mortality*