Diagnosis of tuberculous meningitis: Current scenario from a Tertiary Neurocare Centre in India
| Autor: | Raju Ravikumar, Jyothi Embekkat Kaviyil |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Pathology Tuberculosis Adolescent Leukocytosis 030106 microbiology India Microbial Sensitivity Tests Drug resistance Hospitals Special Polymerase Chain Reaction Sensitivity and Specificity Gastroenterology Tuberculous meningitis Tertiary Care Centers Mycobacterium tuberculosis Young Adult 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid CSF pleocytosis Internal medicine Cytology Tuberculosis Multidrug-Resistant medicine Humans Lymphocytes Child Aged Cerebrospinal Fluid Aged 80 and over Bacteriological Techniques biology business.industry Middle Aged biology.organism_classification medicine.disease Infectious Diseases Neurology Mycobacterium tuberculosis complex Child Preschool Tuberculosis Meningeal Female business 030217 neurology & neurosurgery |
| Zdroj: | Indian Journal of Tuberculosis. 64:183-188 |
| ISSN: | 0019-5707 |
| Popis: | Background Tuberculous meningitis (TBM) is a condition that is caused by Mycobacterium tuberculosis complex and is difficult to diagnose due to the nonspecificity of the presentations. The study analyzed the different modes of diagnosis available in a developing country set up over a period of five years to understand the diagnostic values of the current conventional and automated methods of diagnosis of TBM among the patients suspected with chronic meningitis. Methods A total of 10,281 cerebrospinal fluid samples (CSF) were collected from suspected chronic meningitis patients, of which 790 samples were from individuals who had clinically suspected TBM. The samples were subjected to CSF cytology and staining, culturing, immunological tests, molecular techniques, and methods for detection of drug resistance. Results The TBM patients were predominantly male, with a mean age of 21–40 years. CSF pleocytosis and lymphocytic predominance were noted. Culture had 40.13% positivity among clinically suspected TBM patients. The multidrug-resistant M. tuberculosis (MDR-TB) constituted 3.14% of the total clinical isolates. With IS6110 PCR, a specificity of 92.86% and sensitivity of 100% are seen with an assay threshold of 30 pg/ml. Line probe assay (LPA) using culture isolates had a sensitivity of 97.67% and a specificity of 100%. Direct CSF LPA showed a sensitivity of 96.15% and a specificity of 100%. Conclusions A combination of techniques that involved culture, cytology, and DNA amplification methods was found to be promising in specific, accurate, and rapid detection of M. tuberculosis in the CSF samples from patients. |
| Databáze: | OpenAIRE |
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