Diagnosis of tuberculous meningitis: A comparative analysis of 3 immunoassays, an immune complex assay and the polymerase chain reaction

Miörner, Håkan; Sjöbring, Ulf; Nayak, Pratima; Chandramuki, A

doi:10.1016/0962-8479(95)90002-0

Cited by 45 publications

(21 citation statements)

References 13 publications

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“…The diagnosis of TBM is difficult, particularly in developing countries where the causes of meningitis are highly diverse [2]. In the diagnosis of TBM, PCR has been widely used to detect M. tuberculosis DNA in CSF samples as a more rapid, sensitive and specific diagnostic method as compared to the conventional procedures involving acid-fast microscopy and isolation by culture [15].…”

Section: Discussionmentioning

confidence: 99%

“…Involvement of the Central Nervous System (CNS), particularly meningitis, is the most severe form of tuberculous infection [1]. In the developing countries, 20-60% of the children dying of tuberculosis are known to have brain/ meningeal involvement, in contrast to 5% or less in adults [2]. Autopsy studies from the Indian subcontinent have revealed involvement of the CNS in 65% of patients with tuberculosis [3].…”

Section: Introductionmentioning

confidence: 99%

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Rapid diagnosis of tuberculous meningitis: A comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen

Rafi

Venkataswamy

Ravi

et al. 2007

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rapid diagnosis of tuberculous meningitis: A comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen

Rafi

Venkataswamy

Ravi

et al. 2007

Journal of the Neurological Sciences

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“…Antibody detection. While the detection of antibodies in the CSF to diagnose TBM is rapid, earlier studies evaluating the utility of measuring M. tuberculosis-specific antibodies in the CSF have shown that these techniques are limited by the inability to differentiate acute infection from previous infection and problems with cross-reactivity (91, 94) in addition to variable and often poor sensitivity and specificity (13,33,130,149,159,239) (Table 3). An example of a more recent study shows that measuring antibodies against a 30-kDa protein that is a specific antigen of M. tuberculosis (88) yielded a more promising sensitivity of 92% (89).…”

Section: Molecular and Biochemical Analysismentioning

confidence: 99%

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

et al. 2008

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SUMMARY Tuberculosis of the central nervous system (CNS) is a highly devastating form of tuberculosis, which, even in the setting of appropriate antitubercular therapy, leads to unacceptable levels of morbidity and mortality. Despite the development of promising molecular diagnostic techniques, diagnosis of CNS tuberculosis relies largely on microbiological methods that are insensitive, and as such, CNS tuberculosis remains a formidable diagnostic challenge. Insights into the basic neuropathogenesis of Mycobacterium tuberculosis and the development of an appropriate animal model are desperately needed. The optimal regimen and length of treatment are largely unknown, and with the rising incidence of multidrug-resistant strains of M. tuberculosis, the development of well-tolerated and effective antibiotics remains a continued need. While the most widely used vaccine in the world largely targets this manifestation of tuberculosis, the BCG vaccine has not fulfilled the promise of eliminating CNS tuberculosis. We put forth this review to highlight the current understanding of the neuropathogenesis of M. tuberculosis, to discuss certain epidemiological, clinical, diagnostic, and therapeutic aspects of CNS tuberculosis, and also to underscore the many unmet needs in this important field.

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“…Antibody detection is a promising venue for diagnosis of TBM, because antibodies against Mycobacterium tuberculosis antigens are found in the CSF of patients with TBM [5][6][7]. Previous work in which a few defined mycobacterial antigens were used detected antibodies in ∼60% of TBM cases [6], demonstrating that the method has a potential, albeit limited, diagnostic usefulness.…”

mentioning

confidence: 99%

Detection of Antibody toMycobacterium tuberculosisProtein Antigens in the Cerebrospinal Fluid of Patients with Tuberculous Meningitis

Chandramuki

Lyashchenko²,

Kumari

et al. 2002

J INFECT DIS

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Antibodies against Mycobacterium tuberculosis antigens were detected by enzyme-linked immunosorbent assay in cerebrospinal fluid (CSF) samples obtained from 442 patients with tuberculous meningitis (TBM) and 102 control patients. Antibodies were found in the CSF of 87% of patients with clinical (culture-negative) TBM, 72% of patients with culture-positive TBM, and 65% of patients with autopsy-proven TBM. That anti-M. tuberculosis antibodies were detected in the CSF of patients with clinically diagnosed cases more frequently than in patients with culture-positive cases suggests that the detection of antibodies in CSF tends to decrease as bacillary load increases. Of the patients with clinical TBM who were coinfected with human immunodeficiency virus (HIV), 70% exhibited anti-M. tuberculosis antibody in CSF, which suggests that antibody responses in this group were substantially weaker than those in HIV-negative patients with clinical TBM. Some groups showed a stronger response to certain antigens, which suggests that antigen recognition patterns may be specific for the stage of disease.

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Diagnosis of tuberculous meningitis: A comparative analysis of 3 immunoassays, an immune complex assay and the polymerase chain reaction

Cited by 45 publications

References 13 publications

Rapid diagnosis of tuberculous meningitis: A comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen

Rapid diagnosis of tuberculous meningitis: A comparative evaluation of in-house PCR assays involving three mycobacterial DNA sequences, IS6110, MPB-64 and 65 kDa antigen

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

Detection of Antibody toMycobacterium tuberculosisProtein Antigens in the Cerebrospinal Fluid of Patients with Tuberculous Meningitis

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