Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting
OBJECTIVES: Cryptococcal meningitis (CM) and tuberculous meningitis (TBM) are common in HIV-infected adults in Africa and difficult to diagnose. Inaccurate diagnosis results in adverse outcomes. We describe patterns of meningitis in a Malawian hospital, focusing on features which differentiate CM an...
Gespeichert in:
| Hauptverfasser: | , , , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
14 July 2010
|
| In: |
Tropical medicine & international health
Year: 2010, Jahrgang: 15, Heft: 8, Pages: 910-917 |
| ISSN: | 1365-3156 |
| DOI: | 10.1111/j.1365-3156.2010.02565.x |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1111/j.1365-3156.2010.02565.x
|
| Verfasserangaben: | Danielle B. Cohen, Eduard E. Zijlstra, Mavuto Mukaka, Miriam Reiss, Shizzie Kamphambale, Maarten Scholing, Peter I. Waitt and Florian Neuhann |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 1844966380 | ||
| 003 | DE-627 | ||
| 005 | 20230710134831.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 230510s2010 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/j.1365-3156.2010.02565.x |2 doi | |
| 035 | |a (DE-627)1844966380 | ||
| 035 | |a (DE-599)KXP1844966380 | ||
| 035 | |a (OCoLC)1389805746 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Cohen, Danielle B. |e VerfasserIn |0 (DE-588)1288788657 |0 (DE-627)184489553X |4 aut | |
| 245 | 1 | 0 | |a Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting |c Danielle B. Cohen, Eduard E. Zijlstra, Mavuto Mukaka, Miriam Reiss, Shizzie Kamphambale, Maarten Scholing, Peter I. Waitt and Florian Neuhann |
| 264 | 1 | |c 14 July 2010 | |
| 300 | |a 8 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Gesehen am 10.05.2023 | ||
| 520 | |a OBJECTIVES: Cryptococcal meningitis (CM) and tuberculous meningitis (TBM) are common in HIV-infected adults in Africa and difficult to diagnose. Inaccurate diagnosis results in adverse outcomes. We describe patterns of meningitis in a Malawian hospital, focusing on features which differentiate CM and TBM with the aim to derive an algorithm using only clinical and basic laboratory data available in this resource-poor setting. - METHODS: Consecutive patients admitted with meningitis were prospectively recruited, clinical features were recorded and cerebrospinal fluid (CSF) was examined. - RESULTS: A total of 573 patients were recruited, and 263 (46%) had CSF consistent with meningitis. One hundred and twelve (43%) had CM and 46 (18%) had TBM. CM was associated with high CSF opening pressure and low CSF leukocyte count. Fever, neck stiffness and reduced conscious level were associated with TBM. A diagnostic index was constructed demonstrating sensitivity 83%and specificity 79% for the differentiation of CM and TBM. An algorithm was derived with 92% sensitivity for the diagnosis of CM, but only 58% specificity. - CONCLUSIONS: Although we demonstrate features associated with CM and TBM, a sufficiently sensitive and specific diagnostic algorithm could not be derived, suggesting that the diagnosis of CM and TBM in resource-limited settings still requires better access to laboratory tools. | ||
| 650 | 4 | |a Adult | |
| 650 | 4 | |a AIDS-Related Opportunistic Infections | |
| 650 | 4 | |a Algorithms | |
| 650 | 4 | |a Developing Countries | |
| 650 | 4 | |a Diagnosis, Differential | |
| 650 | 4 | |a Epidemiologic Methods | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Leukocyte Count | |
| 650 | 4 | |a Malawi | |
| 650 | 4 | |a Male | |
| 650 | 4 | |a Medically Underserved Area | |
| 650 | 4 | |a Meningitis, Cryptococcal | |
| 650 | 4 | |a Neck Pain | |
| 650 | 4 | |a Tuberculosis, Meningeal | |
| 700 | 1 | |a Zijlstra, Eduard E. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Mukaka, Mavuto |e VerfasserIn |4 aut | |
| 700 | 1 | |a Reiss, Miriam |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kamphambale, Shizzie |e VerfasserIn |4 aut | |
| 700 | 1 | |a Scholing, Maarten |e VerfasserIn |4 aut | |
| 700 | 1 | |a Waitt, Peter I. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Neuhann, Florian |e VerfasserIn |0 (DE-588)1049921046 |0 (DE-627)78288881X |0 (DE-576)403914159 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Tropical medicine & international health |d Oxford [u.a.] : Wiley-Blackwell, 1996 |g 15(2010), 8 vom: Aug., Seite 910-917 |h Online-Ressource |w (DE-627)320584755 |w (DE-600)2018112-7 |w (DE-576)091015839 |x 1365-3156 |7 nnas |a Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting |
| 773 | 1 | 8 | |g volume:15 |g year:2010 |g number:8 |g month:08 |g pages:910-917 |g extent:8 |a Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting |
| 856 | 4 | 0 | |u https://doi.org/10.1111/j.1365-3156.2010.02565.x |x Verlag |x Resolving-System |z lizenzpflichtig |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20230510 | ||
| 993 | |a Article | ||
| 994 | |a 2010 | ||
| 998 | |g 1049921046 |a Neuhann, Florian |m 1049921046:Neuhann, Florian |d 910000 |d 912800 |e 910000PN1049921046 |e 912800PN1049921046 |k 0/910000/ |k 1/910000/912800/ |p 8 |y j | ||
| 999 | |a KXP-PPN1844966380 |e 4320313593 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"type":{"media":"Online-Ressource","bibl":"article-journal"},"person":[{"given":"Danielle B.","role":"aut","family":"Cohen","display":"Cohen, Danielle B."},{"given":"Eduard E.","family":"Zijlstra","display":"Zijlstra, Eduard E.","role":"aut"},{"role":"aut","family":"Mukaka","display":"Mukaka, Mavuto","given":"Mavuto"},{"role":"aut","display":"Reiss, Miriam","family":"Reiss","given":"Miriam"},{"given":"Shizzie","display":"Kamphambale, Shizzie","family":"Kamphambale","role":"aut"},{"display":"Scholing, Maarten","family":"Scholing","role":"aut","given":"Maarten"},{"role":"aut","display":"Waitt, Peter I.","family":"Waitt","given":"Peter I."},{"display":"Neuhann, Florian","family":"Neuhann","role":"aut","given":"Florian"}],"relHost":[{"pubHistory":["1.1996 -"],"part":{"text":"15(2010), 8 vom: Aug., Seite 910-917","extent":"8","issue":"8","year":"2010","volume":"15","pages":"910-917"},"disp":"Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African settingTropical medicine & international health","recId":"320584755","titleAlt":[{"title":"TM & IH"},{"title":"Tropical medicine and international health"}],"type":{"media":"Online-Ressource","bibl":"periodical"},"title":[{"title":"Tropical medicine & international health","subtitle":"TM & IH","title_sort":"Tropical medicine & international health"}],"physDesc":[{"extent":"Online-Ressource"}],"language":["eng"],"origin":[{"publisherPlace":"Oxford [u.a.] ; Oxford [u.a.]","dateIssuedKey":"1996","dateIssuedDisp":"1996-","publisher":"Wiley-Blackwell ; Blackwell"}],"id":{"zdb":["2018112-7"],"eki":["320584755"],"doi":["10.1111/(ISSN)1365-3156"],"issn":["1365-3156"]}}],"id":{"doi":["10.1111/j.1365-3156.2010.02565.x"],"eki":["1844966380"]},"recId":"1844966380","origin":[{"dateIssuedDisp":"14 July 2010","dateIssuedKey":"2010"}],"language":["eng"],"title":[{"title_sort":"Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting","title":"Diagnosis of cryptococcal and tuberculous meningitis in a resource-limited African setting"}],"physDesc":[{"extent":"8 S."}],"name":{"displayForm":["Danielle B. Cohen, Eduard E. Zijlstra, Mavuto Mukaka, Miriam Reiss, Shizzie Kamphambale, Maarten Scholing, Peter I. Waitt and Florian Neuhann"]},"note":["Gesehen am 10.05.2023"]} | ||
| SRT | |a COHENDANIEDIAGNOSISO1420 | ||