Newer methods over the conventional diagnostic tests for tuberculous meningitis: do they really help?
Rapid diagnosis of tuberculous meningitis (TBM) is crucial as the disease outcome depends on the stage at which the treatment is initiated. The reliability of the available tests has not been established; thus, the present study was conducted to evaluate the conventional diagnostic tests as compared to the newer methods. Cerebrospinal fluid was collected from 100 children, and analyzed for various biochemical and cytological tests. The samples were subjected to Ziehl-Neelsen (Z-N) staining, Lowenstein-Jensen (L-J) culture, BACTEC culture and polymerase chain reaction (PCR). Twenty-two patients could be identified as definitive TBM based on the demonstration of Mycobacterium tuberculosis by BACTEC culture and PCR. Of these 22 cases, Z-N staining was positive in only two and L-J culture in six cases. Both the BACTEC culture and PCR had 100% agreement in the diagnosis of TBM. However, BACTEC culture could be a better diagnostic test as drug sensitivity can also be performed by this method.
Baveja
C P
CP
Department of Microbiology, Maulana Azad Medical College, BSZ Marg, Delhi-110002, India. bavejac@indiatimes.com
Gumma
Vidyanidhi
V
Jain
Manisha
M
Choudhary
Monica
M
Talukdar
B
B
Sharma
V K
VK
D001431:Bacteriological Techniques; D002555:Cerebrospinal Fluid / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D004269:DNA, Bacterial / Q000032:analysis / Q000134:cerebrospinal fluid; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000382:microbiology
D003470:Culture Media; D004269:DNA, Bacterial