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Progress on Diagnosis of Tuberculous Meningitis

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Computational Systems Biology

Part of the book series: Methods in Molecular Biology ((MIMB,volume 1754))

Abstract

Central nervous system (CNS) disease caused by Mycobacterium tuberculosis (MTB) is highly devastating. Tuberculous meningitis (TBM) is the most common form of CNS tuberculosis (TB). Rapid, sensitive, and affordable diagnostic tests are not available. Ziehl–Neelsen (ZN) stain has a very low sensitivity in cases of TBM, the sensitivity rates is of about 10–20%.The detection rate can be improved by taking large volume CSF samples (>6 ml) and prolonged slide examination (30 min). Culture of MTB from the CSF is slow and insufficiently sensitive. The sensitivity is different, which varies from 36% to 81.8%. The microscopic observation drug susceptibility (MODS) assay was recommended by the World Health Organization in 2011. The sensitivity is 65%, which is more sensitive and faster than CSF smear. Commercial PCR assays were found to be insensitive at detecting MTB in CSF samples. Many research provided the value of ADA on the TBM diagnosis. Interferon-gamma release assays (IGRAs) are not recommended for diagnosis of active TB disease. Imaging is essential in diagnosis and showing complications of CNS TB. Thwaites criteria and the Lancet consensus scoring system (LCSS) were developed to improve the diagnosis of TBM. Clinicians will continue to make judgment based on clinical examination, inflammatory CSF examinations, imaging studies, and scoring systems.

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Authors and Affiliations

  1. Department of Neurology, Tianjin Haihe Hospital, Tianjin, P.R. China

    Yi-yi Wang

  2. Department of Neurology, Tianjin Medical University General Hospital, Tianjin, P.R. China

    Bing-di Xie

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  1. Yi-yi Wang
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  2. Bing-di Xie
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Correspondence to Yi-yi Wang .

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Editors and Affiliations

  1. Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China

    Tao Huang

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Wang, Yy., Xie, Bd. (2018). Progress on Diagnosis of Tuberculous Meningitis. In: Huang, T. (eds) Computational Systems Biology. Methods in Molecular Biology, vol 1754. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-7717-8_20

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  • DOI: https://doi.org/10.1007/978-1-4939-7717-8_20

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-7716-1

  • Online ISBN: 978-1-4939-7717-8

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