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Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report
BACKGROUND: Pediatric tuberculous meningitis is a highly morbid, often fatal disease. Its prompt diagnosis and treatment saves lives, in fact delays in the initiation of therapy have been associated with high mortality rates. CASE PRESENTATION: This is a case of an Italian child who was diagnosed wi...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347815/ https://www.ncbi.nlm.nih.gov/pubmed/28288691 http://dx.doi.org/10.1186/s13104-017-2444-9 |
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author | Vita, Serena Ajassa, Camilla Caraffa, Emanuela Lichtner, Miriam Mascia, Claudia Mengoni, Fabio Paglia, Maria Grazia Mancarella, Cristina Colistra, Davide Di Biasi, Claudio Ciardi, Rosa Maria Mastroianni, Claudio Maria Vullo, Vincenzo |
author_facet | Vita, Serena Ajassa, Camilla Caraffa, Emanuela Lichtner, Miriam Mascia, Claudia Mengoni, Fabio Paglia, Maria Grazia Mancarella, Cristina Colistra, Davide Di Biasi, Claudio Ciardi, Rosa Maria Mastroianni, Claudio Maria Vullo, Vincenzo |
author_sort | Vita, Serena |
collection | PubMed |
description | BACKGROUND: Pediatric tuberculous meningitis is a highly morbid, often fatal disease. Its prompt diagnosis and treatment saves lives, in fact delays in the initiation of therapy have been associated with high mortality rates. CASE PRESENTATION: This is a case of an Italian child who was diagnosed with tuberculous meningitis after a history of a month of headache, fatigue and weight loss. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis with predominance and decreased glucose concentration. Microscopy and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non classical method based on intracellular cytokine flow cytometry response of CD4 cells in cerebral spinal fluid helped us to address the diagnosis, that was subsequently confirmed by a nested polymerase chain reaction amplifying a 123 base pair fragment of the M. tuberculosis DNA. CONCLUSIONS: We diagnosed tuberculous meningitis at an early stage through an innovative immunological approach, supported by a nested polymerase chain reaction for detection of M. tuberculosis DNA. An early diagnosis is required in order to promptly initiate a therapy and to increase the patient’s survival. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-017-2444-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5347815 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-53478152017-03-14 Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report Vita, Serena Ajassa, Camilla Caraffa, Emanuela Lichtner, Miriam Mascia, Claudia Mengoni, Fabio Paglia, Maria Grazia Mancarella, Cristina Colistra, Davide Di Biasi, Claudio Ciardi, Rosa Maria Mastroianni, Claudio Maria Vullo, Vincenzo BMC Res Notes Case Report BACKGROUND: Pediatric tuberculous meningitis is a highly morbid, often fatal disease. Its prompt diagnosis and treatment saves lives, in fact delays in the initiation of therapy have been associated with high mortality rates. CASE PRESENTATION: This is a case of an Italian child who was diagnosed with tuberculous meningitis after a history of a month of headache, fatigue and weight loss. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis with predominance and decreased glucose concentration. Microscopy and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non classical method based on intracellular cytokine flow cytometry response of CD4 cells in cerebral spinal fluid helped us to address the diagnosis, that was subsequently confirmed by a nested polymerase chain reaction amplifying a 123 base pair fragment of the M. tuberculosis DNA. CONCLUSIONS: We diagnosed tuberculous meningitis at an early stage through an innovative immunological approach, supported by a nested polymerase chain reaction for detection of M. tuberculosis DNA. An early diagnosis is required in order to promptly initiate a therapy and to increase the patient’s survival. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-017-2444-9) contains supplementary material, which is available to authorized users. BioMed Central 2017-03-13 /pmc/articles/PMC5347815/ /pubmed/28288691 http://dx.doi.org/10.1186/s13104-017-2444-9 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Vita, Serena Ajassa, Camilla Caraffa, Emanuela Lichtner, Miriam Mascia, Claudia Mengoni, Fabio Paglia, Maria Grazia Mancarella, Cristina Colistra, Davide Di Biasi, Claudio Ciardi, Rosa Maria Mastroianni, Claudio Maria Vullo, Vincenzo Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title | Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title_full | Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title_fullStr | Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title_full_unstemmed | Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title_short | Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
title_sort | immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347815/ https://www.ncbi.nlm.nih.gov/pubmed/28288691 http://dx.doi.org/10.1186/s13104-017-2444-9 |
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