The Roles of Thwaites’ and Marais’ Diagnostic Scoring Indexes and a Clinical Prediction Model in the Diagnosis of Tuberculous Meningitis

Karabela, Şemsi Nur; Ünlü, Gülten; Şenoğlu, Sevtap; Ünlü, Esra Canbolat; Korkusuz, Ramazan; Yaşar, Kadriye Kart

doi:10.4274/bmj.galenos.2021.73792

Cited by 2 publications

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“…Similarly, the Marais’ scoring indexes (MDSI) have been found to be useful for rapid diagnosis 6–8 . The MDSI include more detailed clinical and imaging findings compared to the TDSI.…”

Section: Discussionmentioning

confidence: 99%

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Tuberculous meningitis with good outcome following appropriate timing of ventriculoperitoneal shunting for hydrocephalus

Nakao

Fujita

Ishii

et al. 2022

Acute Medicine & Surgery

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Background Tuberculous meningitis is often associated with hydrocephalus. However, the appropriate timing for shunt placement to treat hydrocephalus remains controversial. Case Presentation A 43‐year‐old man presented with high fever and disturbance of consciousness. Cerebrospinal fluid (CSF) findings showed pleocytosis, increased protein levels, and hypoglycemia with an elevated pressure of 30 cm H 2 O. Brain magnetic resonance imaging revealed cerebral infarctions and hydrocephalus resulting in suspicion of tuberculous meningitis. A few days after admission, external ventricular drainage was carried out for acute hydrocephalus. Four antitubercular drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol) as well as dexamethasone sodium phosphate were given. The CSF polymerase chain reaction test for tuberculosis was found to be positive 2 weeks later. Once CSF protein levels improved, a ventriculoperitoneal shunting operation was undertaken. Conclusions When tuberculous meningitis is suspected, treatment with antitubercular drugs should be initiated prior to definitive diagnosis, and a shunt surgery should be carried out in a timely manner.

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“…Similarly, the Marais’ scoring indexes (MDSI) have been found to be useful for rapid diagnosis 6–8 . The MDSI include more detailed clinical and imaging findings compared to the TDSI.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the Marais' scoring indexes (MDSI) have been found to be useful for rapid diagnosis. [6][7][8] The MDSI include more detailed clinical and imaging findings compared to the TDSI. Imaging is particularly important, with hydrocephalus and basal meninges contrast effects being characteristic.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous meningitis with good outcome following appropriate timing of ventriculoperitoneal shunting for hydrocephalus

Nakao

Fujita

Ishii

et al. 2022

Acute Medicine & Surgery

View full text Add to dashboard Cite

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Diagnostic Utility of the “Lancet Consensus Scoring System” in Suspected Cases of Tuberculous Meningitis in Patients Attending a Tertiary Care Hospital in Central India

Patel,

Dadheech,

Sahu

et al. 2024

The International Journal of Mycobacteriology

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Background: Tuberculous meningitis (TBM) is a challenging condition to diagnose, and current laboratory methods have limitations, especially in developing countries. This study evaluated the diagnostic utility of the Lancet consensus scoring (LCS) system in suspected TBM cases at a tertiary care center in India. Methods: The clinical manifestations of 75 patients with suspected TBM were prospectively evaluated using the LCS system, which categorizes cases as “definite” (laboratory confirmed), “probable” (>10 points without imaging or > 12 points with imaging), and “possible” (6–9 points without imaging or 6–11 points with imaging). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the LCS system were compared to GeneXpert and mycobacterial growth indicator tube (MGIT) liquid culture, which are considered the gold standard tests. Results: Out of 75 recruited cases, 11 were confirmed as definite TBM cases. The LCS system correctly identified 8 of these as “probable” and 3 as “possible” cases. Compared to GeneXpert, the LCS system had a specificity of 100%, sensitivity of 54.55%, NPV of 92.7%, and PPV of 100%. Compared to MGIT liquid culture, the LCS system had a specificity of 100%, sensitivity of 81.82%, NPV of 96.97%, and PPV of 100%. The diagnostic accuracy was higher for MGIT liquid culture (97.33%) than GeneXpert (93.33%). Conclusion: The LCS system is a practical and easily applicable tool that can aid the diagnosis of suspected TBM cases, particularly in resource-limited settings. Despite some limitations, the LCS system demonstrated good diagnostic performance, suggesting its potential utility in improving TBM diagnosis and management.

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The Roles of Thwaites’ and Marais’ Diagnostic Scoring Indexes and a Clinical Prediction Model in the Diagnosis of Tuberculous Meningitis

Cited by 2 publications

References 0 publications

Tuberculous meningitis with good outcome following appropriate timing of ventriculoperitoneal shunting for hydrocephalus

Tuberculous meningitis with good outcome following appropriate timing of ventriculoperitoneal shunting for hydrocephalus

Diagnostic Utility of the “Lancet Consensus Scoring System” in Suspected Cases of Tuberculous Meningitis in Patients Attending a Tertiary Care Hospital in Central India

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