scholarly journals Validation of Thwaites' Diagnostic Scoring System for the Differential Diagnosis of Tuberculous Meningitis and Bacterial Meningitis

2014 ◽  
Vol 67 (6) ◽  
pp. 428-431 ◽  
Author(s):  
Yan-liang Zhang ◽  
Su Lin ◽  
Ling-yun Shao ◽  
Wen-hong Zhang ◽  
Xin-hua Weng
2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Yongyan He ◽  
Yueli Zou ◽  
Junying He ◽  
Hui Bu ◽  
Yaling Liu

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.


2021 ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  

Abstract We evaluated the association between hyponatremia and tuberculous meningitis (TBM) in hopes of providing additional information for the differential diagnosis of TBM from other types of infectious meningitis, especially from viral meningitis (VM). Cross-sectional and longitudinal data involving 5,026 participants more than 18 years of age were analyzed in the total population and the propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, VM, and bacterial meningitis (BM) patients were compared. The initial serum sodium levels were significantly lower in the TBM patients than in the VM and BM patients (136.9 ± 5.9 vs. 139.0 ± 3.1, p < 0.001 for TBM vs. VM, and 138.3 ± 4.7 mmol/L and p < 0.001 for TBM vs. BM) and it dropped significantly more steeply to lower levels in both the TBM and BM patients compared to the VM patients. Consequently, the lowest serum sodium levels were in the order of the TBM < BM < VM patients, which were also statistically significant in all subgroups. (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). The participants with lower serum sodium levels were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium levels than the initial sodium levels (OR 8.4 (95% CI: 4.5–15.8, p < 0.001)). The baseline and longitudinal evaluation of serum sodium levels can provide supportive information for the differential diagnosis of TBM from VM or BM.


2018 ◽  
Vol 24 (8) ◽  
pp. 648-653 ◽  
Author(s):  
Sarunyou Chusri ◽  
Thanaporn Hortiwakul ◽  
Natthaka Sathaporn ◽  
Boonsri Charernmak ◽  
Manthana Phengmak ◽  
...  

2018 ◽  
Vol 33 (31) ◽  
Author(s):  
Sang-Ah Lee ◽  
Shin-Woo Kim ◽  
Hyun-Ha Chang ◽  
Hyejin Jung ◽  
Yoonjung Kim ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seunghee Na ◽  
Taewon Kim ◽  
In-Uk Song ◽  
Sung-Woo Chung ◽  
Seong-Hoon Kim ◽  
...  

AbstractWe evaluated the association between hyponatremia and tuberculous meningitis (TBM) with the aim of providing additional information for differential diagnosis from other types of infectious meningitis, especially viral meningitis (VM). Cross-sectional and longitudinal data involving 5026 participants older than 18 years were analyzed in the total population and a propensity-matched population. The initial and lowest sodium levels and longitudinal changes in TBM, bacterial meningitis (BM), and VM patients were compared. Participants in the TBM group were enrolled when they were diagnosed as possible, probable, or definite TBM according to the Marais’ criteria. The initial serum sodium level was significantly lower in TBM patients than in BM and VM patients (136.9 ± 5.9 vs. 138.3 ± 4.7 mmol/L, p < 0.001 for TBM vs. BM, and 139.0 ± 3.1, p < 0.001 for TBM vs. VM), and it decreased significantly more steeply to lower levels in both the TBM and BM patients compared with VM patients. The lowest serum sodium level was in the order of TBM < BM < VM patients, and the change was statistically significant in all subgroups (131.8 ± 6.4, 133.1 ± 5.1, 137.4 ± 3.7, respectively, p < 0.001). Participants with lower serum sodium level were more likely to have a diagnosis of TBM rather than VM, and this association was more pronounced for the lowest sodium level than the initial sodium level [OR 4.6 (95% CI 2.4–8.8, p < 0.001)]. These findings indicate that baseline and longitudinal evaluation of serum sodium level can provide information for differential diagnosis of TBM from BM or VM.


2014 ◽  
Vol 35 (6) ◽  
pp. 637
Author(s):  
Ming YANG ◽  
Xiao-lan ZHANG ◽  
Wei QIAN ◽  
Fan YANG ◽  
Ye CAI ◽  
...  

PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 586-600
Author(s):  
David H. Smith ◽  
David L. Ingram ◽  
Arnold L. Smith ◽  
Floyd Gilles ◽  
M. J. Bresnan

Prior to the introduction of specific antibacterial therapy, bacterial meningitis was a disease with a universally fatal or disastrous outcome. The introduction of typespecific antiserum, and then of the antibacterial drugs, improved this situation dramatically. Improvements in the general medical care of acutely ill children, and the introduction of a series of more potent antibiotics against its bacterial causes helped to generate an attitude that bacterial meningitis was, or soon would be, a disease of the past. The experience of the past two decades belies this thesis. Today, interest in many facets of this disease has been renewed by many physicians concerned with the health of children: the epidemiology, pathophysiology, diagnosis, and treatment. This symposium attempts to summarize for the practitioner the highlights of current knowledge in this area, and to outline certain areas in which recent advances can be anticipated, or will be studied. Tuberculous meningitis will be omitted for the sake of brevity, as will the special problems of meningitis in the newborn infant. There has been a resurgence of interest in developing vaccines to prevent Hemophilus influenzae b, pneumococcal, and meningococcal Group A, B, and C meningitis. These organisms cause almost all the bacterial meningitis after the first two months of life. If, as now seems possible, vaccines against most or all of these organisms will soon become available, those children having the greatest risk must be defined to determine who, and at what age should have priority in receiving the vaccine(s). A. THE CURRENT MAGNITUDE OF THE PROBLEM


PEDIATRICS ◽  
1970 ◽  
Vol 45 (4) ◽  
pp. 717-718
Author(s):  
Manfred Weichsel

Dr. John H. Menkes's review of the factors responsible for the lowering of the spinal fluid sugar in bacterial and tuberculous meningitis1 presents evidence that the primary factors for the low spinal fluid sugar in bacterial meningitis may be a combination of increased utilization of glucose by the brain, combined with a defective glucose transport. We2 presented evidence over 30 years ago that the lowering of the spinal fluid sugar in tuberculous meningitis was not due predominantly to utilization of the glucose by either bacteria or leukocytes:


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