Resumo
Objetivo: Analisar a meningite tuberculosa (MTB) no contexto pediátrico. Revisão bibliográfica: A MTB é uma doença infecciosa e transmissível, causada principalmente por bacilos do Mycobacterium tuberculosis. Tem uma prevalência mundial variável, no qual se apresenta como 10% de todos os casos de tuberculose que é, em média, 100,000 casos anuais. A fisiopatologia da MTB está ligada a disseminação corporal dos bacilos, a passagem por barreiras sanguíneas, a infiltração do sistema nervoso central e a ruptura de lesões em diversas áreas do encéfalo, que causam infecção e inflamação conjunta das meninges. O diagnóstico é feito pela associação de testes biomoleculares, específicos e inespecíficos, além de achados de imagem e na história clínica do paciente. O tratamento da MTB é feito com terapia antituberculose, similar a pulmonar, corticosteroides, acompanhamentos de imagem e terapias de reabilitação durante todo o acompanhamento do indivíduo. Considerações finais: A MTB é uma patologia com necessidade de associação rápida de meios diagnósticos e requer um tratamento o mais precoce permitido para evitar o surgimento de sequelas e complicações permanentes para o paciente.
Referências
BASU ROY R, et al. Defeating pediatric tuberculous meningitis: applying the who “defeating meningitis by 2030: global roadmap”. Microorganisms, 2021; 9(4): 857.
BOYLES TH, et al. Tuberculous Meningitis International Research Consortium. Decision-making in the diagnosis of tuberculous meningitis. Wellcome Open Res, 2020; 5: 11.
CRESSWELL FV, et al. Recent developments in tuberculous meningitis pathogenesis and diagnostics. Wellcome Open Res, 2019; 4: 164.
DANIEL BD, et al. Tuberculous meningitis in children: Clinical management & outcome. Indian J Med Res, 2019; 150(2): 117–30.
DAVIS AG, et al. Neurocognitive and functional impairment in adult and pediatric tuberculous meningitis. Wellcome Open Res, 2019; 4: 178.
DAVIS AG, et al. The pathogenesis of tuberculous meningitis. J Leukoc Biol, 2019; 105(2): 267–80.
DONOVAN J, et al. Tuberculous meningitis: where to from here? Curr Opin Infect Dis, 2020; 33(3): 259– 66.
HOU J, et al. Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review. Ann Med, 2022; 54(1): 2517–21.
HUYNH J, et al. Tuberculous meningitis in children: reducing the burden of death and disability. Pathogens, 2021; 11(1): 38.
IMRAN D, et al. Tuberculous Meningitis International Research Consortium. Establishing the cascade of care for patients with tuberculous meningitis. Wellcome Open Res, 2019; 4: 177.
KAY AW, et al. Xpert MTB/RIF and Xpert MTB/RIF Ultra assays for active tuberculosis and rifampicin resistance in children. Cochrane Database Syst Rev, 2020; 8(8): CD013359.
KAY AW, et al. Xpert MTB/RIF Ultra assay for tuberculosis disease and rifampicin resistance in children. Cochrane Database Syst Rev, 2022; 9(9): CD013359.
MANYELO CM, et al. Tuberculous meningitis: pathogenesis, immune responses, diagnostic challenges, and the potential of biomarker-based approaches. J Clin Microbiol, 2021; 59(3): e01771-20.
PORMOHAMMAD A, et al. A systematic review and meta-analysis of the diagnostic accuracy of nucleic acid amplification tests for tuberculous meningitis. J Clin Microbiol, 2019; 57(6): e01113-18.
SEDDON JA, et al. Tuberculous Meningitis International Research Consortium. The current global situation for tuberculous meningitis: epidemiology, diagnostics, treatment and outcomes. Wellcome Open Res, 2019; 4: 167.
SEID G, et al. Microbiological diagnosis and mortality of tuberculosis meningitis: Systematic review and meta-analysis. PLoS One, 2023; 18(2): e0279203.
SHEN Y, et al. Efficacy of Xpert MTB/RIF Ultra in diagnosing tuberculosis meningitis: A systematic review and meta-analysis. Medicine (Baltimore), 2021; 100(29): e26778.
SHOLEYE AR, et al. Tuberculous granuloma: emerging insights from proteomics and metabolomics. Front Neurol, 2022; 13: 804838.
SSEBAMBULIDDE K, et al. Improving technology to diagnose tuberculous meningitis: are we there yet? Front Neurol, 2022; 13: 892224.
SULIS G, et al. Comparative effectiveness of regimens for drug-susceptible tuberculous meningitis in children and adolescents: a systematic review and aggregate-level data meta-analysis. Open Forum Infect Dis, 2022; 9(6): ofac108.
