Diagnosis Of Tuberculosis Meningitis Research Articles

Profiles of biochemical parameters in central nervous system fluid during the therapeutic courses of adult Mycobacterium tuberculosis meningitis

Clinical features, cerebrospinal fluid (CSF) examination, and neuroimaging findings can yield a presumptive diagnosis of tuberculosis meningitis (TM). However, confirmed diagnosis depends on the culture of Mycobacterium tuberculosis from the CSF [1]. Generally, the decision to begin with tuberculostatic treatment cannot await the proof of the causative agent and the prognosis of the disease may be devastating even if treatment is started promptly [2]. Sometimes the clinicians are confused from the diagnostic burden whether to start therapy for TM or not. In some TM cases without microbiological confirmation, the clinical and laboratory parameters resolve very quickly after the initiation of antibiotics. There remains another controversy in this situation, i.e. whether the clinician will stop therapy or continue for 12 months. There is little knowledge on the changes of CSF biochemical parameters during antituberculosis therapy in TM patients. What happens to the biochemical profile in CSF in due course? To the authors’ knowledge there are no data in the literature on this issue. Our study, which was performed between 1 January 2000 and 31 December 2004, focuses on these CNF changes in biochemical profiles for TM patients receiving therapy. There is a chain of military hospitals over the country in Turkey. If a soldier is diagnosed as TM in 1 of the military hospitals, the patient is given antibiotics and sent home for 2 /3 months of rest following the hospitalization necessary for patient stabilization. The patient returns to hospital either in an emergency situation or following the end of the official rest period. Thus, all TM patients return to military hospitals every 2 to 3 months, but the patient does not necessarily apply to the hospital where the disease is diagnosed. Generally the patient applies to the military hospital nearest to where he lives, i.e. another institution may follow a TM case diagnosed in our hospital in the follow-up periods or we may follow a previously diagnosed case in another military hospital during the therapeutic course. In every periodical visit the patient was punctured once again either to delineate the status of infection or to present an official clue to provide the patient with an additional rest time. After the end of 12-month therapy, the surveillance of the patient is stopped. Therefore we have sparse data on TM patients which we may have encountered at any period during anti-tuberculosis therapy. All the cases were young males ranging from 20 to 28 y of age without immunosuppression. Dexamethasone was given to all patients in standard dosages

Drug Treatment of Tuberculosis Meningitis in Children

Tuberculosis meningitis is the most serious extrapulmonary complication of tuberculosis and the commonest cause of death in childhood as a result of tuberculosis. Appropriate treatment must be started as soon as a diagnosis of tuberculosis meningitis is suspected.

ELISA-its evaluation in diagnosis of tuberculosis meningitis

Diagnostic utility of an enzyme linked immunosorbent assay (ELISA) in hospitalised patients with clinical symptoms suggestive of tuberculous meningitis (94 cases) was studied. CSF Anti-tubercular IgG antibody levels were estimated by ELISA in 44 cases of proven tuberculous meningitis, 24 proven pyogenic meningitis and in 48 non-tuberculous cases. The cut off dilution was established at a CSF dilution of 1 : 1 (undiluted) with positive and negative controls. The ELISA test had a sensitivity of 97.72% and a specificity of 95.35% using MSE antigen. When compared with conventional smear examination and culture isolation from specimens, the ELISA test proved statistically superior in the detection rate or diagnosis of clinically suspected tuberculous meningitis cases (P less than 0.05).