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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar los aspectos cl&#237;nicos&#44; diagn&#243;sticos&#44; terap&#233;uticos y evolutivos de una poblaci&#243;n pedi&#225;trica afectada de meningitis tuberculosa&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se han revisado retrospectivamente las historias cl&#237;nicas de 13 ni&#241;os con este diagn&#243;stico ingresados en el Hospital Infantil Virgen del Roc&#237;o de Sevilla entre 1984 y 1999&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad media fue de 2&#44;35 &#177; 2&#44;3 a&#241;os&#46; Los signos y s&#237;ntomas al ingreso fueron&#58; fiebre en 11 ni&#241;os&#44; anorexia y v&#243;mitos en 8&#44; alteraci&#243;n de conciencia en 7&#46; Seis ni&#241;os&#44; todos mayores de 20 meses&#44; ten&#237;an signos men&#237;ngeos&#59; los 7 restantes presentaban irritabilidad&#44; y 4 de &#233;stos fontanela hipertensa&#46; Se valoraron cl&#237;nicamente 3 pacientes en el estadio I&#44; 9 en el estadio II y uno en el estadio III&#44; seg&#250;n el Medical Research Council&#46; En todos los pacientes los hallazgos de LCR fueron orientativos&#46; La baciloscopia fue positiva en 5 casos y se aisl&#243; Mycobacterium tuberculosis en 6 ni&#241;os&#44; bien en LCR o en aspirado g&#225;strico&#46; El Mantoux se positiviz&#243; en 11 casos&#46; La radiograf&#237;a de t&#243;rax fue patol&#243;gica en 8 ni&#241;os &#40;adenopat&#237;a hiliar en un caso&#44; patr&#243;n miliar en 2&#44; e infiltrado en 5&#41;&#46; La TAC objetiv&#243; una dilataci&#243;n ventricular en todos los casos y el EEG estuvo lentificado en las fases iniciales en 11 casos&#46; Fallecieron 2 ni&#241;os y las complicaciones neurol&#243;gicas fueron las m&#225;s frecuentes&#44; apareciendo en 9 pacientes&#46; Curaron sin secuelas 4 pacientes&#44; el resto presentaron d&#233;ficit cognitivos&#44; visuales y motores&#44; hemiparesias y convulsiones tard&#237;as&#46; No se ha observado ning&#250;n caso en los &#250;ltimos 5 a&#241;os</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El empleo de t&#233;cnicas de diagn&#243;stico r&#225;pido en la identificaci&#243;n de M&#46; tuberculosis ser&#237;a &#250;til para iniciar un tratamiento antituberculoso a un paciente con alta sospecha de afectaci&#243;n men&#237;ngea por este germen&#46; La precocidad del tratamiento disminuir&#225; las complicaciones y secuelas de esta enfermedad&#46; Parece existir una disminuci&#243;n en la incidencia pese al aumento de la infecci&#243;n por el VIH en la actualidad&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our aim was to analyse clinical&#44; diagnostic&#44; therapeutical and evolutionary features in a pediatric population with tuberculous meningitis&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The medical records of thirteen children with this diagnosis admitted to Hospital Infantil Virgen del Roc&#237;o from Seville &#40;Spain&#41; between 1984 and 1999 were reviewed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The mean age was 2&#44;35 &#177; 2&#44;3 years&#46; The symptoms upon admission were&#58; fever in 11 children&#44; anorexia and vomiting in 8&#44; disturbance of the consciousness in 7&#46; Meningeal signs in 6&#44; all of them older than 20 months&#44; the remaining seven showed irritability and four of these ones hypertense fontanelles&#46; Three patients were in the first stage of the disease&#44; 9 in the second and 1 in the third&#44; according to the Medical Research Council&#46; CSF findings were indicatives in all the cases&#46; Five children had bacilloscopy positive and Mycobacterium tuberculosis was isolated in 6 patients&#44; sometimes in CSF others in gastric juice&#46; Mantoux skin test was positive in 11&#46; Radiographic studies demonstrated abnormal chest findings in 8 patients &#40;hiliar adenopathy&#44; 1&#59; miliary pattern&#44; 2&#59; and infiltrates&#44; 5&#41;&#46; Pathology cranial computed tomography showed in all the cases and the electroencephalogram was slowed down in the initial phases in 11&#46; Two children died and the neurological complications were the most frequent&#44; appearing in 9 patients&#46; Without consequences cured 4 patients&#44; the rest presented cognitive&#44; visual and motor deficits&#44; sensibility skin disturbance and late seizures&#46; No case has been observed during the last 5 years&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fast diagnosis tests used for M&#46; tuberculosis identification were useful to begin an antituberculous treatment in a high suspicion of meningeal affectation by this germen patient&#46; The early treatment will decrease complications and consequences by this disease&#46; A decrease in the incidence looks to be in spite of the VIH infection increase nowadays&#46;</p>"
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Meningitis tuberculosa. ¿Una enfermedad en regresión en nuestro medio?
Tuberculous meningitis: a disease in regression in our environment?
J.S. Parrilla Parrilla, N. Sánchez Fernández, C. Cintado Bueno*
Sección de Infectología Pediátrica. Hospital Infantil Universitario Virgen del Rocío. Sevilla
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar los aspectos cl&#237;nicos&#44; diagn&#243;sticos&#44; terap&#233;uticos y evolutivos de una poblaci&#243;n pedi&#225;trica afectada de meningitis tuberculosa&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se han revisado retrospectivamente las historias cl&#237;nicas de 13 ni&#241;os con este diagn&#243;stico ingresados en el Hospital Infantil Virgen del Roc&#237;o de Sevilla entre 1984 y 1999&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La edad media fue de 2&#44;35 &#177; 2&#44;3 a&#241;os&#46; Los signos y s&#237;ntomas al ingreso fueron&#58; fiebre en 11 ni&#241;os&#44; anorexia y v&#243;mitos en 8&#44; alteraci&#243;n de conciencia en 7&#46; Seis ni&#241;os&#44; todos mayores de 20 meses&#44; ten&#237;an signos men&#237;ngeos&#59; los 7 restantes presentaban irritabilidad&#44; y 4 de &#233;stos fontanela hipertensa&#46; Se valoraron cl&#237;nicamente 3 pacientes en el estadio I&#44; 9 en el estadio II y uno en el estadio III&#44; seg&#250;n el Medical Research Council&#46; En todos los pacientes los hallazgos de LCR fueron orientativos&#46; La baciloscopia fue positiva en 5 casos y se aisl&#243; Mycobacterium tuberculosis en 6 ni&#241;os&#44; bien en LCR o en aspirado g&#225;strico&#46; El Mantoux se positiviz&#243; en 11 casos&#46; La radiograf&#237;a de t&#243;rax fue patol&#243;gica en 8 ni&#241;os &#40;adenopat&#237;a hiliar en un caso&#44; patr&#243;n miliar en 2&#44; e infiltrado en 5&#41;&#46; La TAC objetiv&#243; una dilataci&#243;n ventricular en todos los casos y el EEG estuvo lentificado en las fases iniciales en 11 casos&#46; Fallecieron 2 ni&#241;os y las complicaciones neurol&#243;gicas fueron las m&#225;s frecuentes&#44; apareciendo en 9 pacientes&#46; Curaron sin secuelas 4 pacientes&#44; el resto presentaron d&#233;ficit cognitivos&#44; visuales y motores&#44; hemiparesias y convulsiones tard&#237;as&#46; No se ha observado ning&#250;n caso en los &#250;ltimos 5 a&#241;os</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El empleo de t&#233;cnicas de diagn&#243;stico r&#225;pido en la identificaci&#243;n de M&#46; tuberculosis ser&#237;a &#250;til para iniciar un tratamiento antituberculoso a un paciente con alta sospecha de afectaci&#243;n men&#237;ngea por este germen&#46; La precocidad del tratamiento disminuir&#225; las complicaciones y secuelas de esta enfermedad&#46; Parece existir una disminuci&#243;n en la incidencia pese al aumento de la infecci&#243;n por el VIH en la actualidad&#46;</p>"
      ]
      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Our aim was to analyse clinical&#44; diagnostic&#44; therapeutical and evolutionary features in a pediatric population with tuberculous meningitis&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The medical records of thirteen children with this diagnosis admitted to Hospital Infantil Virgen del Roc&#237;o from Seville &#40;Spain&#41; between 1984 and 1999 were reviewed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The mean age was 2&#44;35 &#177; 2&#44;3 years&#46; The symptoms upon admission were&#58; fever in 11 children&#44; anorexia and vomiting in 8&#44; disturbance of the consciousness in 7&#46; Meningeal signs in 6&#44; all of them older than 20 months&#44; the remaining seven showed irritability and four of these ones hypertense fontanelles&#46; Three patients were in the first stage of the disease&#44; 9 in the second and 1 in the third&#44; according to the Medical Research Council&#46; CSF findings were indicatives in all the cases&#46; Five children had bacilloscopy positive and Mycobacterium tuberculosis was isolated in 6 patients&#44; sometimes in CSF others in gastric juice&#46; Mantoux skin test was positive in 11&#46; Radiographic studies demonstrated abnormal chest findings in 8 patients &#40;hiliar adenopathy&#44; 1&#59; miliary pattern&#44; 2&#59; and infiltrates&#44; 5&#41;&#46; Pathology cranial computed tomography showed in all the cases and the electroencephalogram was slowed down in the initial phases in 11&#46; Two children died and the neurological complications were the most frequent&#44; appearing in 9 patients&#46; Without consequences cured 4 patients&#44; the rest presented cognitive&#44; visual and motor deficits&#44; sensibility skin disturbance and late seizures&#46; No case has been observed during the last 5 years&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Fast diagnosis tests used for M&#46; tuberculosis identification were useful to begin an antituberculous treatment in a high suspicion of meningeal affectation by this germen patient&#46; The early treatment will decrease complications and consequences by this disease&#46; A decrease in the incidence looks to be in spite of the VIH infection increase nowadays&#46;</p>"
      ]
    ]
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                            1 => "X&#46; Pastor Dur&#225;n"
                            2 => "A&#46; Hostalot Ab&#225;s"
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                          "etal" => false
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                        0 => array:2 [
                          "etal" => false
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                    ]
                  ]
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                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            0 => "N&#46;I&#46; Girgis"
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                            2 => "M&#46;E&#46; Kilpatrick"
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                        ]
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                          "etal" => false
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Información del artículo
ISSN: 16954033
Idioma original: Español
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2018 Agosto 1 0 1
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2018 Enero 4 0 4
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2016 Julio 18 14 32
2015 Diciembre 1 0 1
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2013 Febrero 6 0 6
2013 Enero 1 0 1
2012 Noviembre 1 0 1
2012 Septiembre 2 0 2
2012 Agosto 3 0 3
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