Tuberculous meningitis in children: Treatment with isoniazid and rifampicin for twelve months

• Published in: The Journal of pediatrics Vol. 114; no. 5; pp. 875 - 879
• Main Authors: Visudhiphan, Pongsakdi, Chiemchanya, Surang
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.1989; Elsevier
• Subjects: Adolescent; Bacterial diseases; Biological and medical sciences; Child; Child, Preschool; Drug Therapy, Combination; Female; Follow-Up Studies; Human bacterial diseases; Humans; Hydrocephalus - etiology; Hydrocephalus - therapy; Infant; Infectious diseases; Intellectual Disability - etiology; Isoniazid - administration & dosage; Male; Medical sciences; Rifampin - administration & dosage; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Meningeal - complications; Tuberculosis, Meningeal - drug therapy; Human; Therapeutic efficiency; Nervous system diseases; Prognosis; Mycobacterial infection; Infection; Chemotherapy; Treatment; Tuberculosis; Bacteriosis; Meningitis; Antituberculous agent; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(89)80157-X

Patients with tuberculous meningitis were treated with isoniazid and rifampicin for 12 months. To evaluate the result of treatment, we studied the outcome of patients treated from January 1979 to December 1985. Of the 51 patients, 27 were female, and 5, 25, and 21 patients were in the first, second, and third stages of the disease, respectively. Increased intracranial pressure of >200 mm H 2O was observed in 42 patients. Three patients required ventriculostomy, and one of them needed ventriculoperitoneal shunting. Three patients died within the first week of admission, and four patients were lost to follow-up. Forty-four patients were followed for 1 1/2 to 7 years; 31 of them recovered completely. Thirteen patients recovered with neurologic sequelae, which included mental retardation, motor weakness, seizures, and hydrocephalus. No serious side effect of the drugs were observed except for transient elevation of liver enzyme activities in four patients. The combination of isoniazid and rifampicin for 1 year, with appropriate management of increased intracranial pressure, seemed to be safe and effective enough to be used as a routine treatment of tuberculous meningitis in areas where resistance to these drugs is uncommon.