Diagnostic criteria for tuberculous meningitis and their validation.
METHODS
Tuberculous meningitis (TBM) has high morbidity and mortality. Demonstration of tubercle bacilli in cerebrospinal fluid (CSF), the only reliable method of diagnosis, is time consuming and has a low yield. Early diagnosis and treatment are of utmost importance for favourable outcome.


OBJECTIVE
The study was conceived to define easy to use criteria.


METHODS
A set of criteria using clinical features, CSF examination and computed tomography (CT) findings were defined. 76 patients suspected of having TBM were divided into definite, highly probable, probable and possible TBM based on the criteria. The validity of criteria was tested using information from bacterial isolation, polymerase chain reaction (PCR) test for tuberculosis, response to treatment and autopsy.


RESULTS
PCR was positive in over 75% of patients in the highly probable and probable groups. 91% of patients with highly probable and 66% with probable TBM improved on antituberculosis therapy.


CONCLUSIONS
The criteria are reliable in making early diagnosis of TBM.
Department of Neurology, All India Institute of Medical Sciences, New Delhi.
G K
GK
Ahuja
K K
KK
Mohan
K
K
Prasad
M
M
Behari
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D006801:Humans; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000000981:diagnostic imaging