Meningitis Tuberkulosis Pada Pasien Dewasa : Kajian Pustaka

Hetti Rusmini, Pad Dilangga, Luther Theng, Apri Lyanda, Gatot Sudiro Hendarto

Sari


Meningitis tuberkulosis (MTB) pada dewasa memiliki mortalitas tinggi akibat inflamasi kompleks, gejala awal yang tidak spesifik, dan keterbatasan diagnostik. Tantangan semakin besar di Indonesia karena keterbatasan fasilitas molekuler dan neuroimaging. Merangkum bukti terbaru mengenai imunopatogenesis, diagnosis modern, dan tantangan klinis MTB pada dewasa, serta implikasinya bagi praktik di Indonesia. Tinjauan literatur naratif melalui PubMed, Scopus, dan Google Scholar menggunakan rentang tahun 2010–2024. Kata kunci meliputi “tuberculous meningitis,” “adult TBM,” “immunopathogenesis TBM,” “CSF biomarkers TB,” dan “Xpert Ultra.” Artikel yang memuat data patofisiologi, diagnosis, atau tatalaksana dewasa disertakan; laporan yang tidak relevan disingkirkan. MTB ditandai aktivasi mikroglia, respons sitokin, dan peningkatan MMP yang menyebabkan kerusakan BBB dan komplikasi neurologis. Analisis CSF dan kultur memiliki sensitivitas rendah, sedangkan GeneXpert/Xpert Ultra dan MRI meningkatkan akurasi diagnosis namun belum tersedia luas. Terapi tetap mengandalkan OAT jangka panjang dan kortikosteroid, sementara regimen lini kedua diperlukan pada resistensi obat. Pendekatan multimodal yang menggabungkan pemahaman patogenesis, pemeriksaan molekuler, dan neuroimaging diperlukan untuk deteksi dini. Peningkatan akses diagnostik dan pengembangan biomarker CSF serta strategi rifampisin dosis tinggi menjadi arah penelitian penting untuk memperbaiki luaran MTB dewasa.


Kata Kunci


Meningitis Tuberkulosis; Tuberkulosis Ekstra Paru; Hidrosefalus

Teks Lengkap:

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Referensi


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DOI: https://doi.org/10.33024/jikk.v12i11.20467

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