Abstract
The appointment of anti-TB drugs with meningitis tuberculous etiology later than the 10 th day of illness in most cases leads to an unfavorable outcome of the disease and the development of serious complications. Specific therapy, conducted by the anti-TB drugs, with a high degree of penetration into the cerebrospinal fluid (isoniazid, pyrazinamide, amikacin, ethionamide) makes it possible to avoid fatal outcome in tuberculous meningitis in children, even at very late diagnosis. For suspected meningitis, and that it cannot be excluded, it is necessary to appoint a trial therapy 3—4 anti-TB drugs while there is a specification of the diagnosis.
Highlights
The appointment of anti-TB drugs with meningitis tuberculous etiology later than the 10th day of illness in most cases leads to an unfavorable outcome of the disease and the development of serious complications
Specific therapy, conducted by the anti-TB drugs, with a high degree of penetration into the cerebrospinal fluid makes it possible to avoid fatal outcome in tuberculous meningitis in children, even at very late diagnosis. That it cannot be excluded, it is necessary to appoint a trial therapy 3—4 anti-TB drugs while there is a specification of the diagnosis
Представленные клинические случаи показывают, что назначение противотуберкулезным препаратам (ПТП), имеющих высокую степень проникновения в СМЖ (изониазид до 90%, пиразинамид до 100%, амикацин от 50 до 90%, этионамид от 40 до 100%), дает возможность избежать летальности при туберкулезных менингитах у детей даже при очень поздней диагностике
Summary
The appointment of anti-TB drugs with meningitis tuberculous etiology later than the 10th day of illness in most cases leads to an unfavorable outcome of the disease and the development of serious complications. Если в доантибактериальную эру туберкулезный менингит у детей практически в 100% случаев заканчивался смертью больного, то в настоящее время считают, что ранняя диагностика и назначение специфической терапии не позднее 10-х сут болезни существенно увеличивают шансы больного на благоприятный исход [1, 5]. С диагнозом «ранний период первичной туберкулезной инфекции (РППТИ), туберкулезный контакт МБТ+» больной была назначена превентивная терапия в стационарных условиях на 6 мес двумя ПТП.
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