Intractable intracranial tuberculous infection responsive to thalidomide: Report of four cases

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dc.contributor.authorSchoeman J.F.
dc.contributor.authorFieggen G.
dc.contributor.authorSeller N.
dc.contributor.authorMendelson M.
dc.contributor.authorHartzenberg B.
dc.date.accessioned2011-05-15T16:16:53Z
dc.date.available2011-05-15T16:16:53Z
dc.date.issued2006
dc.description.abstractParadoxical enlargement and development of new intracranial tuberculomas and tuberculous brain abscesses on adequate antituberculosis treatment are well recognized and supposedly cytokine mediated. These lesions are often unresponsive to conventional antituberculosis treatment, corticosteroids, and surgery. We therefore assessed the effect of adjunctive thalidomide, a tumor necrosis factor α-modulating drug, in intractable intracranial tuberculosis that did not respond to standard medical and surgical therapy. Four consecutive children (three children with bacteriologic proof and one child with clinical evidence of intracranial tuberculosis) were studied. Three patients each had a giant tuberculous abscess, and the fourth had chronic basal arachnoiditis with progressive loss of vision. Three of the four patients had relentless neurologic deterioration, and all showed disease progression on neuroimaging despite full medical and appropriate surgical treatment. Marked clinical and neuroradiologic improvement occurred after thalidomide was added to the antituberculosis treatment regimen of these four patients. Adjunctive thalidomide might have a role in the management of intractable intracranial tuberculosis and needs further investigation in this regard.
dc.description.versionArticle
dc.identifier.citationJournal of Child Neurology
dc.identifier.citation21
dc.identifier.citation4
dc.identifier.issn08830738
dc.identifier.other10.1177/08830738060210040801
dc.identifier.urihttp://hdl.handle.net/10019.1/13975
dc.subjectamikacin
dc.subjectciprofloxacin
dc.subjectcorticosteroid
dc.subjectethionamide
dc.subjectisoniazid
dc.subjectprednisone
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjectthalidomide
dc.subjecttumor necrosis factor alpha
dc.subjectabsence of side effects
dc.subjectadjuvant therapy
dc.subjectarachnoiditis
dc.subjectarticle
dc.subjectbacteriology
dc.subjectbrain abscess
dc.subjectbrain infection
dc.subjectbrain surgery
dc.subjectclinical article
dc.subjectclinical feature
dc.subjectcomputer assisted tomography
dc.subjectdeterioration
dc.subjectdisease course
dc.subjectdrug response
dc.subjectextrapulmonary tuberculosis
dc.subjectfemale
dc.subjecthuman
dc.subjectmale
dc.subjectneuroradiology
dc.subjectnuclear magnetic resonance imaging
dc.subjectpreschool child
dc.subjectpriority journal
dc.subjecttreatment failure
dc.subjectvisual impairment
dc.subjectArachnoiditis
dc.subjectBlindness
dc.subjectBrain
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectDisease Progression
dc.subjectDrug Therapy, Combination
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectImmunosuppressive Agents
dc.subjectInfant
dc.subjectMagnetic Resonance Imaging
dc.subjectMale
dc.subjectThalidomide
dc.subjectTreatment Outcome
dc.subjectTuberculoma, Intracranial
dc.titleIntractable intracranial tuberculous infection responsive to thalidomide: Report of four cases
dc.typeArticle
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