THE DIAGNOSIS AND PATHOPHYSIOLOGY OF TUBERCULOUS MENINGITIS

Approximately 30% of people with tuberculous
meningitis (TBM) die despite modern treatment.
Survival is dependent upon early treatment but
diagnosis is difficult: the clinical features are
non-specific, conventional bacteriology is widely
regarded as insensitive, and newer diagnostic tests
are incompletely evaluated. In addition, the
pathogenesis of TBM remains so poorly understood
that prospects for new interventions to improve
outcome are few. This thesis examines the diagnosis
and pathophysiology of TBM in adults admitted to an
infectious disease hospital in Ho Chi Minh City,
Vietnam. The aim was to address three questions:
what is the best method for distinguishing TBM from
other central nervous system disorders, how does
disease pathophysiology relate to treatment and
clinical outcome, and what other variables influence
prognosis?

Autorentext

Guy E Thwaites, MD PhD. Qualified in Medicine from Cambridge University and Guy's and St Thomas's Hospital. Practices as a Infectious Diseases physician and Clinical Microbiologist. Currently a Wellcome Trust Clinical Research Fellow at Imperial College, London.

Klappentext

Approximately 30% of people with tuberculous meningitis (TBM) die despite modern treatment. Survival is dependent upon early treatment but diagnosis is difficult: the clinical features are non-specific, conventional bacteriology is widely regarded as insensitive, and newer diagnostic tests are incompletely evaluated. In addition, the pathogenesis of TBM remains so poorly understood that prospects for new interventions to improve outcome are few. This thesis examines the diagnosis and pathophysiology of TBM in adults admitted to an infectious disease hospital in Ho Chi Minh City, Vietnam. The aim was to address three questions: what is the best method for distinguishing TBM from other central nervous system disorders, how does disease pathophysiology relate to treatment and clinical outcome, and what other variables influence prognosis?