Analysis of early clinical characteristics in pediatric patients with pulmonary tuberculosis complicated with tuberculous meningitis without neurological symptoms or signs
ZHENG Shengkun
HUANG Shaomei
MA Shangming
GUO Huilian
Abstract：Objective To investigate the early clinical characteristics of pediatric patients with pulmonary tuberculo-sis(PTB)complicated with tuberculous meningitis(TBM)who exhibit no neurological symptoms or signs,in order to pro-vide a reference for clinical diagnosis and treatment.Methods A retrospective study was conducted on 84 pediatric pa-tients newly diagnosed and initially treated for PTB complicated with TBM.Patients were classified into two groups:those without neurological symptoms/signs(NS-PTB-TBM group,n=46)and those with neurological symptoms/signs(S-PTB-TBM group,n=38).Demographic characteristics,laboratory test results,and radiological findings were compared be-tween the groups.Multivariate Logistic regression analysis was used to identify the factors associated with the absence of neurological symptoms/signs in pediatric patients with PTB complicated with TBM.Results Compared with the S-PTB-TBM group,the NS-PTB-TBM group exhibited significantly higher proportions of patients aged≥10 years,cough,malnu-trition,white blood cell counts≥12×109/L,and elevated peripheral blood levels of C-reactive protein(CRP),lactic de-hydrogenase,globulin,and adenosine deaminase(ADA);conversely,albumin and high-density lipoprotein(HDL)lev-els were significantly lower in the NS-PTB-TBM group(all P<0.05).Radiological evaluations demonstrated higher positiv-ity rates for sputum/gastric aspirate Mycobacterium tuberculosis(MTB)smear and nucleic acid amplification tests in the NS-PTB-TBM group,alongside increased frequencies of centrilobular nodules,tree-in-bud signs,hilar/mediastinal lymph-adenopathy,and diffuse miliary changes,and with a lower incidence of calcification(all P<0.05).Multivariate Logistic regression analysis revealed cough,elevated CRP,and elevated ADA were independent factors for the absence of neurolog-ical symptoms/signs at initial diagnosis.Conclusions Pediatric patients with NS-PTB-TBM exhibit more active inflam-matory responses and distinct radiological features at initial diagnosis and treatment.Elevated peripheral blood CRP and ADA levels are independent risk factors for the absence of neurological symptoms or signs in these patients.
Keywords：pulmonary tuberculosistuberculous meningitisneurological symptomsearly diagnosispediatric diseases
Publication Date：2025-04-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 16-20 )