scholarly journals Use of Roche AMPLICOR Mycobacterium tuberculosis PCR in Early Diagnosis of Tuberculous Meningitis

1998 ◽  
Vol 36 (5) ◽  
pp. 1251-1254 ◽  
Author(s):  
Alec Bonington ◽  
J. I. George Strang ◽  
Paul E. Klapper ◽  
Steven V. Hood ◽  
William Rubombora ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mycobacterium Tuberculosis ◽  
Tuberculous Meningitis ◽  
Laboratory Findings ◽  
Antituberculosis Treatment ◽  
Few Data ◽  
A Prospective Study ◽  
Specific Diagnostic Test ◽  
Pcr Test ◽  
Csf Findings

Several nucleic acid-based amplification tests are available for the detection of Mycobacterium tuberculosis, but few data are available on their use in the diagnosis of tuberculous meningitis (TBM). We performed a prospective study to assess the Roche AMPLICORMycobacterium tuberculosis PCR test (TB AMPLICOR) for use in the diagnosis of TBM and compared it with direct Ziehl-Neelsen staining of smears, radiometric culture for M. tuberculosis, and clinical and cerebrospinal fluid (CSF) findings. Eighty-three CSF specimens collected from 69 patients with suspected meningitis in South Africa were tested by TB AMPLICOR. On the basis of clinical and laboratory findings, 40 of these patients were treated for TBM and 29 patients were not treated for TBM. Ten CSF samples from 10 patients were positive by TB AMPLICOR. Seven of these 10 patients were classified as having definite TBM, 2 were classified as having probable TBM, and 1 was classified as having possible TBM. The sensitivity of TB AMPLICOR for detecting cases of definite and probable TBM in patients from whom CSF specimens had been collected less than 10 days into antituberculosis treatment was 60.0%. Specimens from all 29 patients not treated for TBM were negative by the TB AMPLICOR, giving a 100% specificity. TB AMPLICOR is therefore more sensitive than the combination of Ziehl-Neelsen staining of smears and radiometric culture for M. tuberculosis and is a rapid and highly specific diagnostic test for TBM.

scholarly journals Estimation of cerebrospinal fluid cortisol level in tuberculous meningitis

2015 ◽  
Vol 06 (04) ◽  
pp. 541-544 ◽  
Author(s):  
Rohan R. Mahale ◽  
Anish Mehta ◽  
Sudhir Uchil
Keyword(s):  
Cerebrospinal Fluid ◽  
Cortisol Level ◽  
Tuberculous Meningitis ◽  
Morbidity And Mortality ◽  
Cns Involvement ◽  
Tubercular Meningitis ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Appropriate Treatment ◽  
Csf Findings

ABSTRACT Background: Central nervous system (CNS) involvement in tuberculosis is around 5–10%. Of the various manifestations of CNS tuberculosis, meningitis is the most common (70–80%). Delay in diagnosis and treatment results in significant morbidity and mortality. Objective: To study the cerebrospinal fluid (CSF) cortisol levels in tubercular meningitis and compare the levels with controls. Methods: Cross-sectional, prospective, observational, hospital-based study done in 20 patients of tubercular meningitis, 20 patients of aseptic meningitis (AM) and 25 control subjects without any preexisting neurological disorders who have undergone lumbar puncture for spinal anesthesia. Results: Cortisol was detected in all 40 CSF samples of patients (100%). Mean CSF cortisol level was 8.82, 3.47 and 1.05 in tubercular meningitis, AM and controls, respectively. Mean CSF cortisol level in tubercular meningitis was significantly higher as compared to AM and controls (P < 0.0001). Conclusion: Cortisol level estimation in CSF is one of the rapid, relatively inexpensive diagnostic markers in early identification of tubercular meningitis along with CSF findings of elevated proteins, hypoglycorrhachia and lymphocytic pleocytosis. This aids in earlier institution of appropriate treatment and thereby decreasing morbidity and mortality. This is the first study on the estimation of CSF cortisol level in tuberculous meningitis.

A Case Report: The CSF Characteristics of HaNDL Syndrome

2020 ◽  
Vol 13 (2) ◽  
pp. 103-107
Author(s):  
Sarah E. McKay ◽  
Melanie R. F. Greenway
Keyword(s):  
Cerebrospinal Fluid ◽  
Migraine With Aura ◽  
Viral Encephalitis ◽  
Recurrent Stroke ◽  
Unique Case ◽  
Laboratory Findings ◽  
Cerebral Ischemic ◽  
Ischemic Events ◽  
Insight Into ◽  
Csf Findings

BackgroundHeadache and Neurologic Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is a rare and underdiagnosed syndrome that mimics recurrent stroke, migraine with aura, and encephalitis.ObjectiveDescribe the presentation, clinical characteristics, and cerebrospinal fluid (CSF) findings in a patient with HaNDL and provide insight into the importance of the recognition of this syndrome.MethodsThe authors describe a unique case of (HaNDL) during which the patient underwent three lumbar punctures over 26 days.ResultsThe authors demonstrate the natural course of CSF characteristics of a patient with HaNDL, with rising and falling lymphocyte counts. Additionally, the authors provide an example of the clinical presentation of HaNDL, with episodic attacks over the course of 1 month of migraine headache, hemibody paresthesias, hemibody weakness, and encephalopathy.ConclusionsHaNDL is a headache syndrome mimicking viral encephalitis, migraine with aura, and recurrent cerebral ischemic events. While HaNDL is a diagnosis of exclusion, the syndrome's association with characteristic clinical and laboratory findings are important to recognize. Furthermore, a monophasic pattern of CSF lymphocytosis in HaNDL may be observed.Implications for NursingIncreased recognition of this syndrome may help prevent unnecessary tests and treatments when patients present with recurrent episodes.

scholarly journals Randomized Pharmacokinetic and Pharmacodynamic Comparison of Fluoroquinolones for Tuberculous Meningitis

2011 ◽  
Vol 55 (7) ◽  
pp. 3244-3253 ◽  
Author(s):  
Guy E. Thwaites ◽  
Sujata M. Bhavnani ◽  
Tran Thi Hong Chau ◽  
Jeffrey P. Hammel ◽  
M. Estée Török ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Drug Exposure ◽  
Time Curve ◽  
Exposure Response ◽  
Antituberculosis Treatment ◽  
Improved Outcomes ◽  
Days Of Therapy ◽  
Fluid Penetration ◽  
New Treatments

ABSTRACTTuberculous meningitis (TBM) is the most lethal form of tuberculosis, and new treatments that improve outcomes are required. We randomly assigned adults with TBM to treatment with standard antituberculosis treatment alone or in combination with ciprofloxacin (750 mg/12 h), levofloxacin (500 mg/12 h), or gatifloxacin (400 mg/24 h) for the first 60 days of therapy. Fluoroquinolone concentrations were measured with plasma and cerebrospinal fluid (CSF) specimens taken at predetermined, randomly assigned times throughout treatment. We aimed to describe the pharmacokinetics of each fluoroquinolone during TBM treatment and evaluate the relationship between drug exposure and clinical response over 270 days of therapy (Controlled Trials number ISRCTN07062956). Sixty-one patients with TBM were randomly assigned to treatment with no fluoroquinolone (n= 15), ciprofloxacin (n= 16), levofloxacin (n= 15), or gatifloxacin (n= 15). Cerebrospinal fluid penetration, measured by the ratio of the plasma area under the concentration-time curve from 0 to 24 h (AUC0–24) to the cerebrospinal fluid AUC0–24, was greater for levofloxacin (median, 0.74; range, 0.58 to 1.03) than for gatifloxacin (median, 0.48; range, 0.47 to 0.50) or ciprofloxacin (median, 0.26; range, 0.11 to 0.77). Univariable and multivariable analyses of fluoroquinolone exposure against a range of different treatment responses revealed worse outcomes among patients with lower and higher plasma and CSF exposures than for patients with intermediate exposures (a U-shaped exposure-response). TBM patients most likely to benefit from fluoroquinolone therapy were identified, along with exposure-response relationships associated with improved outcomes. Fluoroquinolones add antituberculosis activity to the standard treatment regimen, but to improve outcomes of TBM, they must be started early, before the onset of coma.

scholarly journals A Diagnostic Scoring System for Distinguishing between Tuberculous and Bacterial Meningitis Based on Clinical and Laboratory Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yongyan He ◽  
Yueli Zou ◽  
Junying He ◽  
Hui Bu ◽  
Yaling Liu
Keyword(s):  
Cerebrospinal Fluid ◽  
Bacterial Meningitis ◽  
Cell Count ◽  
Tuberculous Meningitis ◽  
Scoring System ◽  
White Cell Count ◽  
Characteristic Curve ◽  
Chinese Patients ◽  
Laboratory Findings ◽  
Microbial Resources

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.

scholarly journals Modifying Cerebrospinal Fluid Constants for the Tuberculousis Etiology of a Meningitis Case

2019 ◽  
Vol 70 (11) ◽  
pp. 3981-3983
Author(s):  
Ioana Florina Mihai ◽  
Alexandra Largu ◽  
V. Dorobat ◽  
Carmen Manciuc
Keyword(s):  
Cerebrospinal Fluid ◽  
Mycobacterium Tuberculosis ◽  
Tuberculous Meningitis ◽  
Corticosteroid Treatment ◽  
Neurological Complications ◽  
Biological Data ◽  
High Rate ◽  
Mycobacterium Tuberculosis Infection ◽  
Persistent Fever ◽  
Long Time

Tuberculous meningitis is the most lethal form of Mycobacterium tuberculosis infection, with a high rate of neurological complications and sequelae. We present the case of a 6 years old child diagnosed with tuberculous meningitis based on epidemiological, clinical and biological data and who has rapidly developed neurological complications with persistent fever and headache for a long time. Under tuberculostatic, depletion and corticosteroid treatment, the evolution of the disease was slowly favorable.

Sign in / Sign up

Export Citation Format

Share Document