| Popis: |
The prevention of the devastating sequelae of tuberculous meningitis (TBM) requires the availability of a reliable test for the rapid diagnosis of this condition. This study was carried out by enzyme-linked immunosorbent assay (ELISA) to measure antimycobacterial immunoglobulin (Ig) G, IgM and IgA in the cerebrospinal fluid (CSF) of 11 patients with culture-proven TBM using a whole cell sonicate of heat-killed M. tuberculosis antigen (MTb) and Bacilli-Calmette Guerin (BCG) antigens. The findings were compared to controls consisting of 13 CSF specimens from patients with proven pyogenic meningitis (PM) and 20 control CSF specimens from individuals with normal findings. The ELISA sensitivity, specificity, positive predictive and negative predictive values for IgG were 73%, 91%, 73% and 91%, respectively, against both antigens. The optical density results for IgM and IgA in the CSF of patients with TBM and controls were too low against both antigens to be considered in any analysis. Although ELISA for detection of anti-mycobacterial antibodies in the CSF provides improvement over conventional methods of microscopy and culture, this approach still needs considerable refinement to make it suited for routine clinical use. |
