Evidence map›Paper›PMID 30564491›Full record

ArticleNeurology. Clinical practice2018

Presentation, etiology, and outcome of brain infections in an Indonesian hospital: A cohort study.

Darma Imran, Riwanti Estiasari, Kartika Maharani, Sucipto, Delly Chipta Lestari, Reyhan Eddy Yunus, Evy Yunihastuti, Teguh Haryono Karyadi, Diana Oei, Ina S Timan and 16 more

Open access · bronzeAbstract read

PubMed Full text at PMC Publisher

In one paragraph

Article in Neurology. Clinical practice, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it

0cells of the map it votes in

14citing papers in PubMed, 1 pooled it

2.1field-weighted citation impact, top 13% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

Systematic review of tuberculous meningitis in high-risk populations: mortality and diagnostic disparities.Future microbiology
Pooled it
HIV-related neurological complications in Cameroon in the era of Test and Treat strategy: prevalence and mortality.BMC infectious diseases · 2026
Article
Nanomaterials: an overview of current trends and future prospects in neurological disorder treatment.Journal of translational medicine · 2025
Review
Clinical presentation, management, and outcome of suspected central nervous system infections in Indonesia: a prospective cohort study.Infection · 2024
Article
A pediatric case and literature review of mucormycosis: Diagnostic and treatment challenges in a resource poor setting.Narra J · 2023
Article
Central nervous system infection in a pediatric population in West Java.PLoS neglected tropical diseases · 2023
Article
Cerebral toxoplasmosis in HIV-infected patients: a review.Pathogens and global health · 2023
Review
Cerebral toxoplasmosis with neurological co-infection in people living with AIDS/HIV: results of a prospective cohort in São Paulo, Brazil.Arquivos de neuro-psiquiatria · 2023
Observational
MRI-based radiomics signature for identification of invisible basal cisterns changes in tuberculous meningitis: a preliminary multicenter study.European radiology · 2022
Article
Metabolomic Characterization of Cerebrospinal Fluid from Intracranial Bacterial Infection Pediatric Patients: A Pilot Study.Molecules (Basel, Switzerland) · 2021
Article
Isolation and identification ofAccess microbiology · 2020
Article
Establishing the cascade of care for patients with tuberculous meningitis.Wellcome open research · 2019
Review
High dose oral rifampicin to improve survival from adult tuberculous meningitis: A randomised placebo-controlled double-blinded phase III trial (the HARVEST study).Wellcome open research · 2019
Article
Pathogen spectrum identified by targeted nanopore sequencing and exploratory analysis of hematological biomarkers in suspected intracranial infections.Frontiers in neurology
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors at 3 institutions in 1 country.

Darma ImranDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Riwanti EstiasariDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Kartika MaharaniDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

SuciptoDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Delly Chipta LestariDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Reyhan Eddy YunusDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Evy YunihastutiDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Teguh Haryono KaryadiDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Diana OeiDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Ina S TimanDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Dewi WulandariDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Retno WahyuningsihDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Robiatul AdawiyahDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Agnes KurniawanDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Rahmad MulyadiDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Anis KaruniawatiDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Ungke Anton JayaDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Dodi SafariDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Arjan van LaarhovenDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Bachti AlisjahbanaDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Sofiati DianDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Lidya ChaidirDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Ahmad Rizal GaniemDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Diatri Nari LastriDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Khin Saw Aye MyintDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Reinout van CrevelDepartments of Neurology (DI, RE, KM, Sucipto, DO, DNL), Microbiology (DCL, A. Karuniawati), Radiology (REY, RM), Internal Medicine (EY, THK), Clinical Pathology (IST, DW), and Parasitology (RW, RA, A. Kurniawan), Cipto Mangunkusumo Hospital-Faculty of Medicine Universitas Indonesia; Eijkman Institute for Molecular Biology (UAJ, DS, KSAM); Eijkman-Oxford Clinical Research Unit (UAJ), Jakarta, Indonesia; Department of Internal Medicine and Radboud Center for Infectious Diseases (AvL, RvC), Radboud University Medical Center, Nijmegen, the Netherlands; TB/HIV Research Center (BA, SD, LC, ARG), Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; and Centre for Tropical Medicine and Global Health (RvC), Nuffield Department of Medicine, University of Oxford, UK.

Padjadjaran University · IDEijkman Institute for Molecular Biology · IDOxford University Clinical Research Unit Indonesia

Funding

NCEZID CDC HHS U18 CK000443

6 · The paper itself

Abstract

backgroundLittle detailed knowledge is available regarding the etiology and outcome of CNS infection, particularly in HIV-infected individuals, in low-resource settings.

methodsFrom January 2015 to April 2016, we prospectively included all adults with suspected CNS infection in a referral hospital in Jakarta, Indonesia. Systematic screening included HIV testing, CSF examination, and neuroimaging.

resultsA total of 274 patients with suspected CNS infection (median age 26 years) presented after a median of 14 days with headache (77%), fever (78%), seizures (27%), or loss of consciousness (71%). HIV coinfection was common (54%), mostly newly diagnosed (30%) and advanced (median CD4 cell count 30/µL). Diagnosis was established in 167 participants (65%), including definite tuberculous meningitis (TBM) (n = 44), probable TBM (n = 48), cerebral toxoplasmosis (n = 48), cryptococcal meningitis (n = 14), herpes simplex virus/varicella-zoster virus/cytomegalovirus encephalitis (n = 10), cerebral lymphoma (n = 1), neurosyphilis (n = 1), and mucormycosis (n = 1). In-hospital mortality was 32%; 6-month mortality was 57%. The remaining survivors had either moderate or severe disability (36%) according to Glasgow Outcome Scale.

conclusionIn this setting, patients with CNS infections present late with severe disease and often associated with advanced HIV infection. Tuberculosis, toxoplasmosis, and cryptococcosis are common. High mortality and long-term morbidity underline the need for service improvements and further study.

Identifiers

PMID30564491

DOI10.1212/CPJ.0000000000000517

PMCPMC6276332

OpenAlexW2890018358

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