title: Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis.
abstract: Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal liquids, are good candidates to be studied using PCR techniques. We detail our experience with a PCR assay applied to pleural and cerebrospinal fluids using the primer MPB64. Seventy three specimens were analyzed: 30 pleural fluids (PF), 26 pleural biopsies (PB) and 17 cerebrospinal fluids (CSF). The gold standard for the diagnosis of tuberculous meningitis was the positive culture for M. tuberculosis in CSF. Tuberculous pleural effusion was diagnosed when cultures of PF and/or PB were positive for M. tuberculosis, or the PB histology showed granulomas. Our results, compared to the gold standards employed, showed a sensitivity of 70%, specificity of 88%, positive predictive value of 82% and negative predictive value of 80%. The high specificity of the MPB64 fragment while still retaining a good sensitivity makes it very well suited for pleural and cerebrospinal tuberculosis diagnosis.
authors.affiliation: Medical School, Marilia, SP, Brazil.
authors.forename: L C
authors.initials: LC
authors.lastname: Martins
authors.forename: I A
authors.initials: IA
authors.lastname: Paschoal
authors.forename: A
authors.initials: A
authors.lastname: Von Nowakonski
authors.forename: S A
authors.initials: SA
authors.lastname: Silva
authors.forename: F F
authors.initials: FF
authors.lastname: Costa
authors.forename: L S
authors.initials: LS
authors.lastname: Ward
mesh_terms: D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000235:genetics*; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000175:diagnosis*; D014396:Tuberculosis, Pleural / Q000175:diagnosis*
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080865:MPB64 protein, Mycobacterium