Place of radical surgery in tuberculosis treatment of central nervous system in combination with HIV infection
https://doi.org/10.22328/2077-9828-2022-14-4-80-86
Abstract
Objective. On the basis of own material determine the role of radical surgery methods in treating tubercular formations of the brain in HIV-infected patients.
Materials and Methods. Studied: statistical forms of the SSPB of the IOKB from 2008 to 2020, FTBPR data from 2017 to 2020, nature of the disease in 56, long-term disease dynamics — in 8, the autopsy material of 331 dead and the biopsy — 9 patients operated on with central nervous system damage (CNS).
Results and Discussion. The number of patients with tuberculous meningoencephalitis increases in the structure of in-patient facilities, case-fatality rate among them grows. Need for neurosurgical care among the survivors is 25%. Long-term monitoring of operatively treated patients shows their higher survival rate, significant clinical effect of surgery, lengthening of life, increase of CD4 lymphocytes by 2,7 times in 3,5 years after the surgery. Formation of restrictive processes around tuberculous lesion in CNS was noted when taking ART with low immune status.
Conclusion. Radical removal of tubercular formations of CNS in HIV is reasonable.
About the Authors
C. I. Petrov
Irkutsk Medical Academy of Postgraduate Education; Irkutsk Regional Clinical Hospital
Russian Federation
Russian Federation
Irkutsk
О. N. Novitskaya
Irkutsk Regional Tuberculosis Hospital
Russian Federation
Russian Federation
Irkutsk
References
1. Arutyunov A. I., Zozulya Yu. A., Oganesyan S. S. Tuberculosis of the brain. Kiev: State Medical Publishing house of the Ukrainian SSR, 1959. 199 p. (In Russ.)].
2. Ulitin A.Yu., Olyushin V.E., Razmologova O.Yu., Savchenko A.I., Shcherbinin A.V. Tuberculosis of the brain: a clinical case and a literature review. Neurosurgery, 2007, No. 1, pp. 40–44 (In Russ.)].
3. Rajshekhar V. Surgery for brain tuberculosis: a review // Acta Neurochir. 2015. Vol. 157, No. 10. P. 1665–1678. PMID: 26170188. doi: 10.1007/s00701-015-2501-x.
4. Sharma M., Velho V., Kharosekar H. A rare case of an isolated intraventricular tuberculoma with a dismal outcome: an unusual location of a com-mon pathology and lessons learnt // Indian J. Tuberc. 2014. Vol. 61, No. 2. P. 166–170.
5. Tewary R.K., O’Sullivan M.G., Ali T.A., O’Sullivan P.G. Intracranial tuberculoma — a diagnostic dilemma // J. Laryngol. 2005. Vol. 119, No. 6. P. 486–488. PMID: 15992480. doi: 10.1258/0022215054273061.
6. Yadegarynia D., Merza M.A., Sali S., Seghatoleslami Z.S. Multiple intracranial tuberculomas in a post-kidney transplant patient // Saudi J Kidney Dis Transpl. 2016. Vol. 27, No. 1. P. 135–138. PMID: 26787580 DOI: 10.4103/1319-2442.174163.
7. Filippova T.P., Novitskaya O.N., Bykov Yu.N., Kornilova Z.H. HIV-associated tuberculosis of the central nervous system in a region with a high level of tuberculosis and HIV infection. Moscow: Publishing house R. Valent, 2012. 132 p. (In Russ.)].
Review
For citations:
Petrov C.I., Novitskaya О.N. Place of radical surgery in tuberculosis treatment of central nervous system in combination with HIV infection. HIV Infection and Immunosuppressive Disorders. 2022;14(4):80-86. (In Russ.) https://doi.org/10.22328/2077-9828-2022-14-4-80-86
Views:
324
.png)
Email this article 