title: Comparative utility of cytokine levels and quantitative RD-1-specific T cell responses for rapid immunodiagnosis of tuberculous meningitis.
abstract: The rapid diagnosis of tuberculous meningitis (TBM) is problematic. We found in 150 patients with suspected TBM that, similar to RD-1-specific quantitative cerebrospinal fluid (CSF) T-cell responses, unstimulated CSF gamma interferon (IFN-γ) levels when used together with other rapid confirmatory tests (Gram stain and cryptococcal latex agglutination test) may allow the accurate and rapid diagnosis of TBM in a setting in which tuberculosis (TB) and HIV are endemic. In resource-poor settings, a clinical prediction rule (CPR) may be useful to clinicians, and thus the IFN-γ assay may potentially need to be used only when the clinical score is below a prespecified threshold. These preliminary findings will need to be confirmed in further studies.
authors: Department of Neurology, University of KwaZulu Natal, Mayville, Durban, South Africa.
authors: Vinod B
authors: VB
authors: Patel
authors: Ravesh
authors: R
authors: Singh
authors: Cathy
authors: C
authors: Connolly
authors: Victoria
authors: V
authors: Kasprowicz
authors: Thumbi
authors: T
authors: Ndung'u
authors: Keertan
authors: K
authors: Dheda
mesh_terms: D002555:Cerebrospinal Fluid / Q000737:chemistry* / Q000166:cytology*; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007159:Immunologic Tests / Q000379:methods*; D007371:Interferon-gamma / Q000134:cerebrospinal fluid* / Q000378:metabolism*; D013601:T-Lymphocytes / Q000276:immunology*; D014390:Tuberculosis, Meningeal / Q000175:diagnosis*
chemical_list: D007371:Interferon-gamma