Document 0931
 DOCN  M9470931
 TI    [Tuberculous meningitis caused by resistant microorganisms.
       Therapeuticfailure in 2 patients with HIV infection and disseminated
       tuberculosis]
 DT    9409
 AU    Fortun J; Gomez-Mampaso E; Navas E; Hermida JM; Antela A; Guerrero A;
       Seccion de Enfermedades Infecciosas, Hospital Ramon y Cajal,; Madrid.
 SO    Enferm Infecc Microbiol Clin. 1994 Mar;12(3):150-3. Unique Identifier :
       AIDSLINE MED/94281313
 AB    BACKGROUND: Tuberculosis in HIV infected patients does not carry a worse
       therapeutic response rate. Treatment failure is usually due to
       incomplete schedule, with development of acquired resistance. Two
       patients with HIV infection and disseminated tuberculosis who developed
       fatal meningitis are presented. METHODS: In vitro studies of sensitivity
       to anti-tuberculous drugs were carried out, using the proportions
       method. RESULTS: Following a good initial evolution, both patients were
       readmitted with tuberculous meningitis resistant to isoniazide in both
       and to rifampicin in one of the patients. In one patient, the original
       strain (which was sensitive) was available. In this patient, changes in
       the treatment were performed in the initial phase. CONCLUSIONS: The
       importance of anti-tuberculous multiple therapy, particularly in the
       initial phases, for HIV positive patients is crucial. The lengthen of
       admission when good patient's compliance is in question, but also to
       avoid, whenever possible, changes in treatment are important measures in
       this stage. Meningitis may occur as a form of therapeutic failure and
       its cure may be difficult if the strains are resistant.
 DE    Adult  Antibiotics, Combined/*THERAPEUTIC USE  Antitubercular
       Agents/*THERAPEUTIC USE  AIDS-Related Opportunistic Infections/DRUG
       THERAPY/*MICROBIOLOGY  Case Report  Drug Resistance, Microbial  English
       Abstract  Fatal Outcome  Human  Isoniazid/PHARMACOLOGY/THERAPEUTIC USE
       Male  Mycobacterium tuberculosis/DRUG EFFECTS  Pyrazinamide/THERAPEUTIC
       USE  Rifampin/PHARMACOLOGY/THERAPEUTIC USE  Streptomycin/THERAPEUTIC USE
       Tuberculosis, Meningeal/DRUG THERAPY/*MICROBIOLOGY
       Zidovudine/THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).