Tuberc Respir Dis > Issue 18; 1964 > Article
Tuberculosis and Respiratory Diseases 1964;18:5-14.
DOI: https://doi.org/10.4046/trd.1964.18.1.5    Published online December 1, 1964.
CLINICAL OBSERVATlON OF TUBERCULOUS MENlNGlTlS IN CHILDHOOD
Youbg Shik Shin, Byung Tae Kim, Im Dong Kim, Dong Sup Han
Department of Pediatrics, School of Medicine, Kyung Pook University, Taegu, Korea
Abstract
During the last 10 years since 1954, statistical radiological studies and analyses of the effects of the chemotherapy were done on 105 children with tuberculous meningitis, aged 4 months to 14 years and 8 months old. The results were as follows: 1) The statistical studies indicated a gradual increase in the incidence after 1960. Concerning the age difference, the highest incidence was noted in the group of the children from 2 to 6 years old, and numbers of the infants and children under 6 years old were 74.3% of the total patients. Concerning sex difference, the incidence of the male patients were slightly higher than that of the female patients. Concerning the seasonal difference the incidence in spring was found to be the highest. The source of the infection was mainly familial and this was found only in 17.1% of the cases with the established infectious sources. As the initial manifestations, vomiting and fever were complained from most of the patients. In many of the cases, it took more than 3 weeks to establish the diagnosis. 2) Concerning the radiologic findings. 93.5% of the cases were found to have abnormal findings in the chest X-ray pictures. As a whole, calcified primary complex was the most. However, as the age difference, primary complex was found in most of the patients less than 2 years old and that of calcified primary complex in most of the patients, 2 to 6 years old and in most of the patients older than 6 years old. 3) The effect of the chemotherapy and prognosis on the cases were analyzed. Annual survival rate was slightly elevated since 1957. The total survival rate of the last 10 years was 40% at present. Concerning the age difference, the patients less than 1 year old showed the lowest rate, that was 25% at present. Concerning the difference dependent on the chemotherapeutic drugs, the follow-up study indicated that a combination therapy using INH mainly with Steroid Hormone was best, showing the survival rate of 44.4%. Concerning relationship between the length of the treatment period and the survival rate, it was found that the rate of the patients receiving the treatment for more than 12 months was 97%, while no patient survived by the treatment for shorter than 2 months. Concerning relationship between the survival rate and the length from the noset of the disease to the starting of the treatment. the follow-up study indicated the highest rate(56.9%) in the group with treatment started within a week after the onset. The rate became remarkably low when the treatment was delayed. The survival rate was 18.4% in the group of the patients, who showed disturbance in the consciousness already on the admission, and almost all of them developed sequelae. As sequelae hemiplegia(motor disturbance) was found mostly.


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