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CC BY-NC-ND 4.0 · J Lab Physicians 2010; 2(01): 021-024
DOI: 10.4103/0974-2727.66705
Original Article

Laboratory Diagnosis of Tuberculous Meningitis – Is There a Scope for Further Improvement?

Rajeev Thakur
Department of Microbiology, Institute of Human Behavior and Allied sciences (IHBAS), New Delhi, India
,
Renu Goyal
Department of Microbiology, Institute of Human Behavior and Allied sciences (IHBAS), New Delhi, India
,
Smita Sarma
Department of Microbiology, Institute of Human Behavior and Allied sciences (IHBAS), New Delhi, India
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Source of Support: Nil
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ABSTRACT

Aims: Tuberculous meningitis (TBM) still remains a diagnostic challenge because of inconsistent clinical presentation and lack of rapid, sensitive and specific tests. This study was carried out to diagnose TBM by a combination of direct microscopy on Ziehl-Neelsen (ZN) staining, culture by conventional Lowenstein Jensen (LJ) media and Bactec MGIT 960 system in clinically suspected cases, supported by laboratory parameters.

Materials and Methods: A total of 164 cerebrospinal fluid (CSF) samples from suspected cases of TBM were processed for direct acid fast bacilli (AFB) smear examination, and culture on Bactec MGIT 960 and LJ media.

Results: AFB were detected on direct smears in 13 of 164 (7.9%) specimens and Mycobacterium tuberculosis was isolated by at least one of the culture methods from 49 (29.8%) CSF samples, of which 45 (27.4%) were detected positive for M. tuberculosis by MGIT 960 culture and 18 (10.9%) by culture on LJ medium. The mean time of detection in MGIT and LJ media for M. tuberculosis were 18 and 38 days, respectively.

Conclusions: A combination of laboratory parameters like smear microscopy, conventional culture and automated method like Bactec MGIT increases the sensitivity of diagnosing TBM as compared to any single method.

Keywords

Bactec MGIT 960 - cerebrospinal fluid - tuberculous meningitis


Publikationsverlauf

Artikel online veröffentlicht:
29. Januar 2020

© 2010.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • REFERENCES

  • 1 Dietrich G, Viret JF, Hess J. Mycobacterium bovis BCG based vaccine against tuberculosis: novel developments. Vaccine 2003;21:667-70.
  • 2 RNTCP guidelines. Training module for medical practitioners. Central TB division. Directorate General of health services, Ministry of Health and family welfare, Nirman Bhawan, New Delhi. Available from: http:// www.tbcindia.org. [last accessed on 2008 Oct 22].
  • 3 Katti MK. Pathogenesis, diagnosis, treatment, and outcome aspects of cerebral tuberculosis. Med Sci Monit 2004;10:RA215-29.
  • 4 Venkataswamy MM, Rafi W, Nagarathna S, Ravi V, Chandramuki A. Comparative evaluation of Bactec 460TB system and Lowenstein Jensen medium for the isolation of M. tuberculosis from cerebrospinal fluid samples of tuberculous meningitis patients. Ind J Med Microbiol 2007;25:236-40.
  • 5 Somoskövi A, Ködmön C, Lantos A, Bártfai Z, Tamási L, Füzy J, et al. Comparison of recoveries of Mycobacterium tuberculosis using the Automated BACTEC MGIT 960 System, the BACTEC 460 TB System, and Löwenstein-Jensen Medium. J Clin Microbiol 2000;38:2395-7.
  • 6 Chew WK, Lasaitis RM, Schio FA, Gilbert GL. Clinical evaluation of the Mycobacteria Growth Indicator Tube (MGIT) compared with radiometric (Bactec) and solid media for isolation of Mycobacterium species. J Med Microbiol 1998;47:821-7.
  • 7 Lu D, Heeren B, Dunne WM. Comparison of the Automated Mycobacteria Growth Indicator Tube System (BACTEC 960/MGIT) with Lowenstein-Jensen medium for recovery of mycobacteria from clinical specimens. Am J Clin Pathol 2002;118:542-5.
  • 8 Debiasi RL, Tyler KL. Molecular methods for diagnosis of viral encephalitis. Clin Microbiol Rev 2004;17:903-25.
  • 9 Bonington A, Strang JI, Klapper PE, Hood SV, Rubombora W, Penny M, et al. Use of Roche AMPLICOR Mycobacterium tuberculosis PCR in early diagnosis of tuberculous meningitis. J Clin Microbiol 1998;36:1251-4.
  • 10 Rishi S, Sinha P, Malhotra B, Pal N. A comparative study for the detection of mycobacteria by bactec MGIT 960, Lowenstein Jensen media and direct AFB smear examination. Indian J Med Microbiol 2007;25:383-6.
  • 11 Rodrigues CS, Shenai SV, Almeida D, Sadani MA, Goyal N, Vadher C, et al. Use of Bactec 460 Tb system in the diagnosis of tuberculosis. Indian J Med Microbiol 2007;25:32-6.
  • 12 Oberoi A, Kaur H. Comparison of rapid colorimetric method with conventional method in isolation of Mycobacterium tuberculosis. Indian J Med Microbiol 2004;22:44-6.
  • 13 Negi SS, Khan SF, Gupta S, Pasha ST, Khare S, Lal S. Comparison of the conventional diagnostic modalities, bactec culture and polymerase chain reaction test for diagnosis of tuberculosis. Indian J Med Microbiol 2005;23:29-33.
  • 14 Forbes BA, Sahm DF, Weissfeld AS.(Eds). Meningitis and other infections of Central Nervous system, chapter 58 In: Bailey and Scott’s Diagnostic Microbiology, 11th ed. (The CV Mosby company,St. Louis) 2002:907.
  • 15 Sankar MM, Kumar P, Munawwar A, Singh J, Parashar D, Singh S. Recovery of Mycobacterium tuberculosis from sputum treated with Cetyl Pyridinium Chloride. J Clin Microbiol 2009;47:4189-90.
  • 16 Desai D, Nataraj G, Kulkarni S, Bichile L, Mehta P, Baveja S, et al. Utility of the polymerase chain reaction in the diagnosis of tuberculous meningitis. Res Microbiol 2006;157:967-70.