Diagnostic usefulness of a T-cell-based assay in patients with miliary tuberculosis compared with those with lymph node tuberculosis.
Forty-three patients with miliary tuberculosis were evaluated for diagnostic usefulness of enzyme-linked immunospot (ELISPOT) assay. Among noninvasive rapid tests available within 3-5 days, ELISPOT had the highest sensitivity (93%), compared with acid-fast bacilli stain (sputum, 32% and bronchoalveolar lavage, 7%), Mycobacterium tuberculosis polymerase chain reaction (sputum, 53% and bronchoalveolar lavage, 36%), and tuberculin skin test (22%). In comparison with 44 patients with lymph node tuberculosis, the sensitivity of the ELISPOT assay in patients with miliary tuberculosis (93%) was as high as in those with lymph node tuberculosis (95%, P = .63), whereas the sensitivity of the tuberculin skin test was substantially lower in patients with miliary tuberculosis (22%) than in those with lymph node tuberculosis (73%, P < .001).
Department of Infectious Diseases, Asan Medical Center,  University of Ulsan College of Medicine, Seoul,  South Korea.
Yu-Mi
YM
Lee
Ki-Ho
KH
Park
Sun-Mi
SM
Kim
Su Jin
SJ
Park
Sang-Oh
SO
Lee
Sang-Ho
SH
Choi
Yang Soo
YS
Kim
Jun Hee
JH
Woo
Sung-Han
SH
Kim
D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology; D058501:Enzyme-Linked Immunospot Assay; D006801:Humans; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism; D014374:Tuberculin Test; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism; D014391:Tuberculosis, Miliary / Q000175:diagnosis* / Q000276:immunology / Q000378:metabolism
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C117940:CFP-10 protein, Mycobacterium tuberculosis; C093276:ESAT-6 protein, Mycobacterium tuberculosis