Atualizações no Manejo Diagnóstico da Neurotuberculose
Revisão Integrativa de Literatura
DOI:
https://doi.org/10.36557/2674-8169.2026v8n9p1187-1215Palavras-chave:
Neurotuberculose, Diagnóstico, BiomarcadoresResumo
Introdução: A neurotuberculose é a manifestação extrapulmonar mais grave da infecção pelo Mycobacterium tuberculosis, caracterizada por alta morbimortalidade. Seu diagnóstico precoce permanece um desafio clínico em virtude da apresentação inespecífica e da natureza paucibacilar da infecção no sistema nervoso central, o que limita a eficácia dos métodos microbiológicos tradicionais. Objetivo: Sintetizar as evidências científicas mais recentes acerca das estratégias clínicas, laboratoriais e radiológicas que compõem o atual manejo diagnóstico da neurotuberculose. Metodologia: Trata-se de uma revisão integrativa da literatura realizada nas bases de dados PubMed/MEDLINE e EMBASE. Utilizou-se a estratégia PICo e as diretrizes PRISMA para a seleção de artigos originais publicados nos últimos cinco anos, resultando na inclusão de 28 estudos. Resultados e Discussão: A transição para métodos moleculares (como Xpert MTB/RIF Ultra, mNGS, sequenciamento de nanoporos e TB-LAMP) demonstrou superioridade significativa em acurácia e rapidez sobre as culturas lentas. Adicionalmente, a associação de biomarcadores no líquido cefalorraquidiano (ADA, IGRAs, procalcitonina e marcadores proteicos) com escores clínicos preditivos, como o Consenso da Lancet, otimiza a triagem diagnóstica. A neuroimagem mantém-se indispensável para a identificação de complicações estruturais precoces. Conclusão: O manejo diagnóstico da neurotuberculose consolidou-se em uma abordagem multimodal. A integração de biologia molecular avançada, escores clínicos e descentralização do acesso nos sistemas de saúde é imperativa para superar os atrasos diagnósticos e melhorar o prognóstico dos pacientes.
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Copyright (c) 2026 Gabriel Braz de Menezes, Michel Reis Abdalla
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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