{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T04:33:21Z","timestamp":1780547601815,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Central nervous system tuberculosis (CNS\u2010TB) is a rare complication of tuberculosis. There is a lack of data surrounding investigation and management of this in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review CNS\u2010TB cases in Western Sydney, Australia, and understand the epidemiology, investigation, diagnosis, management and outcomes in a low\u2010prevalence setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective cohort study of all CNS\u2010TB patients managed in Western Sydney from 2013 to 2022. Demographics, risk factors, clinical presentation, investigations and management were reviewed. Clinical outcomes like hospital length\u2010of\u2010stay, adverse drug reactions, paradoxical reactions, functional disability and treatment outcomes, including cure, treatment failure, loss to follow\u2010up and death, were also measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine CNS\u2010TB cases were identified, with 16 (41%) confirmed by nucleic acid amplification test or culture of CNS specimens and 23 (59%) diagnosed presumptively without CNS microbiological confirmation. The median age was 32\u2009years. Thirty\u2010seven (95%) were overseas\u2010born; 27 (69%) had no comorbidities. Presenting symptoms included fever (82%), headache (64%) and weight loss (51%). Twenty\u2010five (64%) used fluoroquinolones and nine (23%) used high\u2010dose rifampicin. Steroids were used in all patients. Six (15%) were prescribed aspirin for primary stroke prevention. Twenty\u2010eight (73%) completed treatment, with one requiring re\u2010treatment for presumed treatment failure. Six (15%) were lost to follow\u2010up, and five (13%) died during their treatment course. Twenty\u2010one (54%) experienced an adverse drug reaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tuberculosis is an ongoing public health issue in Australia, with CNS\u2010TB being its most devastating form, and all clinicians to be aware of this rare complication. The efficacy of newer treatment options requires further study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70017","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T09:37:33Z","timestamp":1742377053000},"page":"822-832","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Central nervous system tuberculosis in Western Sydney: a 10\u2010year retrospective cohort study"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0404-0096","authenticated-orcid":false,"given":"Hayden","family":"Zhang","sequence":"first","affiliation":[{"name":"Infectious Diseases Department Blacktown Hospital  Blacktown New South Wales Australia"},{"name":"School of Medicine Western Sydney University  Blacktown New South Wales 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