ABSTRACT
Con el objetivo de describir las manifestaciones clínicas de pacientes con meningoencefalitis por tuberculosis (TBC), se realizó un estudio descriptivo, retrospectivo mediante la revisión de historias clínicas de 15 pacientes adultos, evaluados por el servicio de Neurología en el SAHUM durante el periodo de Enero 2002 a Diciembre 2008. Se analizó: edad, sexo, procedencia, manifestaciones clínicas, tiempo entre el inicio de los síntomas y la hospitalización y tratamiento. De los 15 pacientes, 10 (66,67%) fueron de sexo femenino, 9 (60,0%) entre 20 y 29 años de edad. El 53,34% eran procedentes de los Municipios Mara y Páez. Las manifestaciones clínicas fueron; cefalea y rigidez de nuca 14 (93,33%), alteración de la consciencia 13 (86,67%), alteración mental 7 (46,66%), convulsión 8 (53,33%), hipertensión intracraneana 5 (33,33%), déficit Motor 3 (20,00%), alteración de pares craneales 2 (13,33%) como falso signo localizador y en 2 (13,33%) diplopía. La citoquímica del líquido cefalorraquídeo reveló hipoglucorraquia en el 100,00% de los pacientes e hiperproteinorraquia. La coloración de Ziehl Neelsen fue positiva en 1 (6,67%). 6 pacientes (40,00%) tenían más de 1 mes con TBC. Se concluye que son diversas las manifestaciones clínicas de meningoencefalitis por TBC, siendo más frecuente el síndrome meníngeo
With the objective of describing clinical manifestations in patients with meningeal encephalitis due to tuberculosis (TBC), a descriptive, retrospective study was made by reviewing clinical histories of 15 adult patients with a diagnosis of TBC in the SAHUM neurology service from January 2002 to December 2008. Age, sex, clinical manifestations, hospitalization and treatment were analyzed. Of the 15 patients, 10 (66.67%) were female, 9 (60.0%) were between 20 and 29 years of age; 53.34% came from the Mara and Páez Municipalities. The clinical manifestations were: headache and nape of the neck rigidity, 14 (93.33%); alteration of consciousness, 13 (86.67%); alteration of mental state, 7 (46.66%); convulsions, 8 (53.33%); intracranial hypertension, 5 (33.33%); motor deficit, 3 (20.00%); alteration of cranial pairs, 2 (13.33%) as a false locator sign and diplopia, 2 (13.33%). Cytochemical study of the cerebrospinal fluid revealed hypoglycorrhachia in 100.00% of the patients. Ziehl Neelsen coloration was positive in 1 (6.67%). Six patients (40.00%) had had the disease for more than 1 month. Conclusions were that the clinical manifestations of meningeal encephalitis due to TBC are diverse, with the meningeal syndrome as the most frequent
Subject(s)
Humans , Male , Adult , Female , Anthrax/pathology , Meningoencephalitis/diagnosis , Tuberculosis/pathologyABSTRACT
Creatinine clearence as a measure of glomerular filtration rate has several sources of error such as tubular creatinine secretion or faulty urine collections. On the other hand 51Cr-EDTA test is reliable and accurate, except in patients with edema, in whom the radioisotope equilibrium is retarded after injection. Aim: to validate a 4 hours creatinine clearence correlating it with 51Cr-EDTA test. Methods: In 59 non insulin dependent diabetic patients without diabetic nephropathy, glomerular filtration rate was measured using one 50 µCi injection of 51Cr-EDTA and collecting blood samples for radioactivity measurement at 10, 30, 120 and 240 min. Simultaneously, creatinine clearence was measured using a 4 hours urine collection. Results: The general correlation coefficient between both methods was 0,85 (p<0,001). For glomerular filtration rates below 95 ml/min, the correlation coefficient was 0,8(p<0,001), for values between 95 and 127 ml/min, the correlation was 0,51(p<0,001) and for values over 127 ml/min the correlation was 0,8(p<0,001). The regression equation obtained was y=1,2x+13 where y was the glomerular filtration rate measured with 51Cr-EDTA and x the same value measured with creatinine clearence. Conclusions: The four hours creatinine clearence is a reliable method to estimate glomerular filtration rate