ABSTRACT

Tuberculous meningitis (TBM) is now uncommon in high-income countries. It is the most severe form of extrapulmonary tuberculosis with high rates of mortality and morbidity if diagnosis and treatment are delayed. An 8-month-old girl with TBM who was treated with high-dose intravenous anti-tuberculous drugs (ATD) is reported. Therapeutic drug monitoring (TDM) of isoniazid and rifampicin was undertaken by measuring serial drug concentrations in serum and cerebrospinal fluid (CSF). There was rapid eradication of Mycobacterium tuberculosis from the CSF with a good clinical outcome and no adverse effects. Using high-dose regimens of intravenous ATD to treat TBM is an important option in order to obtain sufficient CSF diffusion. When available, TDM and a multidisciplinary approach are essential for efficient therapeutic management.

摘要

结核性脑膜炎 (TBM) 现在在高收入国家并不常见。如果延误诊断和治疗，它是最严重的肺外结核病，死亡率和发病率都很高。报道一名 8 个月大的 TBM 女孩接受大剂量静脉注射抗结核药物 (ATD) 治疗。通过测量血清和脑脊液 (CSF) 中的连续药物浓度进行异烟肼和利福平的治疗药物监测 (TDM)。结核分枝杆菌被迅速根除从脑脊液中提取，临床结果良好，无不良反应。使用大剂量静脉 ATD 治疗 TBM 是获得足够 CSF 扩散的重要选择。如果可用，TDM 和多学科方法对于有效的治疗管理至关重要。