Abstract
Confirmation of infection with Mycobacterium tuberculosis (MTB) in a patient with clinical signs and symptoms of tuberculosis is important for individual treatment, household contact investigation, and disease surveillance. Laboratory methods include smear microscopy of clinical specimens, cultures on liquid and solid media, and rapid nucleic acid amplification tests. The availability of these diagnostics varies widely between and within countries. Although these methods have good high sensitivities for the detection of MTB in sputum samples, they cannot reliably rule out tuberculous meningitis (TBM) in cerebrospinal fluid. The decision to initiate treatment for TBM should be based on strong clinical suspicion even with negative laboratory assays for MTB.
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