Cargando…

Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?

AIMS: Tuberculous meningitis (TBM) still remains a diagnostic challenge because of inconsistent clinical presentation and lack of rapid, sensitive and specific tests. This study was carried out to diagnose TBM by a combination of direct microscopy on Ziehl-Neelsen (ZN) staining, culture by conventio...

Descripción completa

Detalles Bibliográficos
Autores principales: Thakur, Rajeev, Goyal, Renu, Sarma, Smita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147081/
https://www.ncbi.nlm.nih.gov/pubmed/21814402
http://dx.doi.org/10.4103/0974-2727.66705
_version_ 1782209291626741760
author Thakur, Rajeev
Goyal, Renu
Sarma, Smita
author_facet Thakur, Rajeev
Goyal, Renu
Sarma, Smita
author_sort Thakur, Rajeev
collection PubMed
description AIMS: Tuberculous meningitis (TBM) still remains a diagnostic challenge because of inconsistent clinical presentation and lack of rapid, sensitive and specific tests. This study was carried out to diagnose TBM by a combination of direct microscopy on Ziehl-Neelsen (ZN) staining, culture by conventional Lowenstein Jensen (LJ) media and Bactec MGIT 960 system in clinically suspected cases, supported by laboratory parameters. MATERIALS AND METHODS: A total of 164 cerebrospinal fluid (CSF) samples from suspected cases of TBM were processed for direct acid fast bacilli (AFB) smear examination, and culture on Bactec MGIT 960 and LJ media. RESULTS: AFB were detected on direct smears in 13 of 164 (7.9%) specimens and Mycobacterium tuberculosis was isolated by at least one of the culture methods from 49 (29.8%) CSF samples of which 45 (27.4%) were detected positive for M. tuberculosis by MGIT 960 culture and 18 (10.9%) by culture on LJ medium. The mean time of detection in MGIT and LJ media for M. tuberculosis were 18 and 38 days, respectively. CONCLUSIONS: A combination of laboratory parameters like smear microscopy, conventional culture and automated method like Bactec MGIT increases the sensitivity of diagnosing TBM as compared to any single method.
format Online
Article
Text
id pubmed-3147081
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher Medknow Publications
record_format MEDLINE/PubMed
spelling pubmed-31470812011-08-03 Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement? Thakur, Rajeev Goyal, Renu Sarma, Smita J Lab Physicians Original Article AIMS: Tuberculous meningitis (TBM) still remains a diagnostic challenge because of inconsistent clinical presentation and lack of rapid, sensitive and specific tests. This study was carried out to diagnose TBM by a combination of direct microscopy on Ziehl-Neelsen (ZN) staining, culture by conventional Lowenstein Jensen (LJ) media and Bactec MGIT 960 system in clinically suspected cases, supported by laboratory parameters. MATERIALS AND METHODS: A total of 164 cerebrospinal fluid (CSF) samples from suspected cases of TBM were processed for direct acid fast bacilli (AFB) smear examination, and culture on Bactec MGIT 960 and LJ media. RESULTS: AFB were detected on direct smears in 13 of 164 (7.9%) specimens and Mycobacterium tuberculosis was isolated by at least one of the culture methods from 49 (29.8%) CSF samples of which 45 (27.4%) were detected positive for M. tuberculosis by MGIT 960 culture and 18 (10.9%) by culture on LJ medium. The mean time of detection in MGIT and LJ media for M. tuberculosis were 18 and 38 days, respectively. CONCLUSIONS: A combination of laboratory parameters like smear microscopy, conventional culture and automated method like Bactec MGIT increases the sensitivity of diagnosing TBM as compared to any single method. Medknow Publications 2010 /pmc/articles/PMC3147081/ /pubmed/21814402 http://dx.doi.org/10.4103/0974-2727.66705 Text en Copyright: © Journal of Laboratory Physicians http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Thakur, Rajeev
Goyal, Renu
Sarma, Smita
Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title_full Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title_fullStr Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title_full_unstemmed Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title_short Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?
title_sort laboratory diagnosis of tuberculous meningitis – is there a scope for further improvement?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147081/
https://www.ncbi.nlm.nih.gov/pubmed/21814402
http://dx.doi.org/10.4103/0974-2727.66705
work_keys_str_mv AT thakurrajeev laboratorydiagnosisoftuberculousmeningitisisthereascopeforfurtherimprovement
AT goyalrenu laboratorydiagnosisoftuberculousmeningitisisthereascopeforfurtherimprovement
AT sarmasmita laboratorydiagnosisoftuberculousmeningitisisthereascopeforfurtherimprovement