Diagnostic risk factors to differentiate tuberculous and acute bacterial meningitis

Moghtaderi, Ali; Alavi-Naini, Roya; Izadi, Shahrokh; Cuevas, Luís E.

doi:10.1080/00365540902721384

Cited by 46 publications

(52 citation statements)

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“…Five features were predictive of a diagnosis of tuberculous meningitis: age, length of history (duration of illness), WBC count, total CSF white-cell count, and CSF neutrophil proportion. Several studies have confirmed these findings [30] and added other discriminating features such as protein count, headache [31], and focal deficit [32]. In our series, of these factors, only length of history and WBC count were significantly different between groups.…”

Section: Discussionsupporting

confidence: 74%

Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis

Cámara-Lemarroy

Delgado‐García

Cruz-Gonzalez

et al. 2017

J Infect Dev Ctries

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Introduction: Mean platelet volume (MPV) has been shown to reflect the inflammatory burden in different inflammatory and autoimmune diseases. Our objective was to analyze the MPV in patients with tuberculous (TBM) and bacterial meningitis (BM). Methodology: The demographic and clinical data of 73 consecutive patients that presented with either BM (n = 35) or TBM (n = 38) were retrospectively analyzed, as well as that of 28 age-and sex-matched controls. Results: MPV was 8.78 ± 1.58 fL in patients with BM and 6.42 ± 1.39 fL in the TBM group (p < 0.05). In the control group, MPV was 7.4 ± 0.66 fL, significantly higher and lower when compared with TBM and BM, respectively. MPV was significantly associated with diagnosis (adjusted OR: 5.15, 95% CI: 1.090-23.7; p = 0.03). With the optimal cut-off value of 7.62 fL, MPV had 82% sensibility and 78% specificity for the differential diagnosis of TBM versus BM. Lower platelet counts, higher serum creatinine, higher white blood cell counts, and higher blood-cerebrospinal fluid glucose ratio were also predictive of BM. Conclusions: Platelet counts were lower and MPV was higher in patients with BM compared to patients with TBM. Platelet indices, available in routine bloodwork, could be useful in the early differential diagnosis of these entities.

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Section: Discussionsupporting

confidence: 74%

Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis

Cámara-Lemarroy

Delgado‐García

Cruz-Gonzalez

et al. 2017

J Infect Dev Ctries

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“…Head injury, invasive operation, fever, headache, nausea/vomiting, disturbance of consciousness, the pupil size of both eyes not being equal, pupillary reaction to light being slow or absent, the prescribed antimicrobial received and the prescribed immunosuppressant/hormone received were predictive of a diagnosis of meningitis. Several studies have confirmed these findings [52][53][54]. In our study, of these factors, only head injury, headache, disturbance of conscious-ness and pupillary reaction to light being slow or absent were significantly different among the three groups.…”

Section: Discussionsupporting

confidence: 78%

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

Chen¹,

Hu²,

Liu³

2017

Arch Med Sci Civil Dis

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A b s t r a c t Introduction:The aim was to investigate the distribution, antibiotic resistance, initial clinical and laboratory characteristics of pathogens isolated from the cerebrospinal fluid samples (CSF). Material and methods: The CSF were subjected for identification. The minimum inhibitory concentrations (MICs) of antimicrobial agents were tested. The initial clinical and laboratory characteristics were collected. Results: The rate of positive yield of pathogen meningitis in our study was 8.16% . Among the 1994 non-repetitive pathogens, Gram-positive pathogen was the most common (71.71%), followed by Gram-negative pathogen (20.36%), fungal (6.62%) and Mycobacterium tuberculosis (1.30%). Coagulase-negative staphylococci (CNS) was the most common Gram-positive pathogen and Acinetobacter baumannii (Ab) was the most common Gram-negative pathogen. As to fungal pathogen, Cryptococcus neoformans (CN) was the most common. The main CNS showed higher antimicrobial resistant rate for Penicillin G, oxacillin, clindamycin and erythromycin. Acinetobacter baumannii resistant to the most tested antibiotics and only showed considerable rate of resistance to cefoperazone/sulbactam, tigecycline and amikacin. All CN were susceptible to 5-fluorocytosine and only 3.6% CN were resistance to fluconazole. Long days of hospital stay, fever and meningeal irritation signs were common symptoms in the bacterial and fungal meningitis. Head injury, disturbance of consciousness, the pupil size of both eyes was not equal, pupillary reaction to light was slow or absent were more common in the Ab meningitis. The CSF protein concentration and white blood cells count as well as glucose concentration can be used in guiding initial treatment and further microbiological investigation. Conclusions: The main pathogens showed higher antimicrobial resistant rate and the selection of empiric antibiotics should take into consideration local epidemiology, antibiotic resistance patterns and the suspected causative microorganism.

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“…The detection of microorganisms in CSF samples by microscopy or culture techniques is crucial for the differential diagnosis of TBM and BM (7,8). However, low positive rates in these techniques render early diagnosis difficult.…”

Section: Discussionmentioning

confidence: 99%

Validation of Thwaites' Diagnostic Scoring System for the Differential Diagnosis of Tuberculous Meningitis and Bacterial Meningitis

et al. 2014

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SUMMARY:To compare the clinical features of patients with tuberculous meningitis (TBM) and bacterial meningitis (BM) and to validate Thwaites' diagnostic scoring system for the differential diagnosis of TBM and BM, a retrospective review of 211 patients with TBM or BM who were admitted to Huashan Hospital, Fudan University, from 2007 to 2012 was conducted. The clinical characteristics and laboratory data were compared, and Thwaites' diagnostic scores were assessed at the time of admission for the differential diagnosis of TBM and BM. Significant differences were observed between the 2 groups in general information, clinical features, and cerebrospinal fluid characteristics. The sensitivity and specificity of Thwaites' diagnostic scoring system for the differential diagnosis of TBM and BM were found to be 98.2z and 43.6z, respectively, with positive and negative predictive values being 65.9z and 95.8z, respectively. The sensitivity and specificity for the differential diagnosis of TBM and initially treated BM were 98.2z and 82.9z, respectively, but were only 98.2z and 24.2z for that of TBM and partially treated BM, respectively. Thus, Thwaites' diagnostic scoring system was found to be highly effective for the differential diagnosis of TBM and initially treated BM but was found to be less effective for that of TBM and partially treated BM.

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Diagnostic risk factors to differentiate tuberculous and acute bacterial meningitis

Cited by 46 publications

References 0 publications

Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis

Mean platelet volume in the differential diagnosis of tuberculous and bacterial meningitis

The microbiology and clinical characteristics of bacterial and fungal meningitis in a Chinese hospital

Validation of Thwaites' Diagnostic Scoring System for the Differential Diagnosis of Tuberculous Meningitis and Bacterial Meningitis

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