Abstract
It is very difficult to diagnose and distinguish tuberculous meningitis, and the current laboratory methods are unsubstantial in developing countries. The study is aimed at creating a scoring system on the basis of basic laboratory and clinical achievements that could be used as diagnostic aid for tuberculous meningitis for Chinese patients. A retrospective study of cases was conducted for comparison between clinical characteristics and laboratory features of 241 patients on admission who conformed to inclusion criteria of tuberculous meningitis (n = 141) or bacterial meningitis (n = 100). Logistic regression was employed to establish a diagnostic formula to distinguish between tuberculous meningitis and bacterial meningitis. The receiver operating characteristic curve analysis was applied to determine the best diagnostic critical point of the diagnostic formula. It was found that five variables (disease course, white blood cell count, serum sodium, total white cell count of cerebrospinal fluid, and neutrophil proportion in cerebrospinal fluid) were independently associated with tuberculous meningitis. The 87% sensitivity and 94% specificity were included in the diagnostic scoring system derived from these variables. Especially in the case of limited microbial resources, doctors can use this diagnostic scoring system to distinguish tuberculous meningitis from bacterial meningitis.
Highlights
Tuberculous meningitis (TBM) still is regarded as a common infection in the central nervous system (CNS), especially in areas, such as China, where have a high prevalence of tuberculosis
mycobacterium tuberculosis (MTB) was isolated from the cerebrospinal fluid (CSF) of 141 patients, 27 cases were positive by ZN and Xpert, 108 cases were positive by ZN alone, and 6 cases were positive by Xpert alone
The vast majority of patients (59%) with definite TBM were classified as stage III, whereas only 8% patients presented to be in stage I
Summary
Tuberculous meningitis (TBM) still is regarded as a common infection in the central nervous system (CNS), especially in areas, such as China, where have a high prevalence of tuberculosis. Clinical manifestations and biochemical features in CSF of TBM are similar to other infections of CNS, especially bacterial meningitis (BM) which is partially treated. Authors have tried to describe clinical features and laboratory parameters which are predictive in the early diagnosis of TBM via applying logistic regression to build a diagnostic method, suitable for areas where tuberculosis is common and limited resources are issues [6,7,8].
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