Performance of newer and conventional diagnostic methods in detection of drug sensitive and resistant tuberculous meningitis

Neelakantan, Sangamithra; Jain, Amita; Singh, Pooja; Prakash, Shantanu; Dixit, Pratibha; Kalyan, Rajkumar; Garg, Ravindra Kumar; Kumar, Rashmi; Singh, Mastan

doi:10.1016/s2222-1808(14)60698-8

Cited by 3 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to acid fast staining, the incidence of culture positivity also increases with repeat culture especially with large volume of cerebrospinal fluid samples. However, variable rate of culture positivity in have also been reported [8,13,27].…”

Section: Discussionmentioning

confidence: 99%

“…The conventional methods were shown to be less sensitive than PCR and it was suggested that PCR can be adopted for the routine diagnosis of TBM. [4,[7][8] In a yet another study, 162 patients cerebrospinal fluid samples was evaluated by real time PCR assay for the early and specific diagnosis of TBM [2]. Various other studies have also indicated the higher positivity rates of PCR assay over the conventional methods.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of TBM is always presumptive and mostly relies on presentation of clinical symptoms, tuberculin testing, cerebrospinal fluid findings, tomography scan, and the response to anti-tuberculosis drugs. Low sensitivity and slow growth hampers the diagnosis at an early stage [4,[7][8]. Therefore, high degree of suspicion is justified for the diagnosis of TBM, which represents non-specific symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…A direct acid-fast bacilli smear from cerebrospinal fluid is of diagnostic value but usually also suffers with false negative and low positive results of suspected TBM cases. Further, culture requires long incubation period of 6-8 weeks and is often negative in result [4,[7][8]. Number of other methods as adenosine deaminase assay, RIA, and ELISA has also been used previously for the diagnosis of TBM [3,[9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, molecular methods based on DNA/RNA have been proven to a good choice as they can detect as low as 2-3 organisms [3]. Amongst various methods, polymerase chain reaction (PCR) based methods are rapid, easy, cost effective, sensitive and specific as compared to other tests [3][4][5][6][7][8][9][10][13][14]. Despite its advantages over conventional methods, which usually result in false positive/negative results, the PCR technique has not been adopted in the diagnosis of TBM, yet.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Utility of polymerase chain reaction technique in the diagnosis of tubercular meningitis in Indian children

Baveja¹,

Singh²,

Talukdar³

et al. 2019

IJAM

View full text Add to dashboard Cite

Despite tremendous advancement, tuberculosis remains a major global health problem due to multidrug resistance and HIV infection. In children's, tubercular meningitis (TBM) is the main presentation than that of pulmonary as after disease neurological problems, are more serious. Timely and accurate diagnosis is important for correct treatment and better outcome. The conventional methods (microscopy and culture) are reported either to give false results or fail to respond at early stage. The molecular biology techniques have offered a ray of hope over it. Methods: In the present study, 30 suspected cases of TBM along with 15 controls representing other forms of meningitis and of pediatric age group were diagnosed using PCR and conventional methods. Results: Only two samples showed positivity by microscopy and six samples showed positivity by culture. On the other hand by PCR, a significantly higher number (17, including microscopy and culture positive) were positive for the presence of TBM. All the control samples were negative by both the methods. Conclusions: PCR was able to detect additional 11 cases reportedly negative by culture and microscopy. It shows that a big quantum left undiagnosed and hence untreated. These results suggest that PCR definitely have an advantage over conventional methods especially in case of TBM where non-treatment due to poor diagnosis may lead to high morbidity and mortality. More emphasis needs to be given to the adoption of such rapid diagnostic methods in case of infections where the start of treatment may affect the infection outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%