Utility of several methods for etiological diagnosis in patients with tuberculous meningitis / 中国感染与化疗杂志

ABSTRACT

ObjectiveTo examine the clinical utility of four methods in diagnosis of tuberculous meningitis.Methods A total of 60 patients with tuberculous meningitis were included as study group and another 70 patients with non-tuberculous intracranial infection as control group. Four methods, including conventional acid fast stain,Myobacterium tuberculous culture in BACTEC MGIT 960, real-time lfuorescent quantitative polymerase chain reaction (FQ-PCR) and modiifed acid fast stain, were used to assay the cerebrospinal lfuid specimens for diagnosis of tuberculous meningitis.ResultsThe positive rate was 11.7% (7/60), 6.7% (4/60), 48.3% (29/60), and 61.7% (37/60), respectively in the study group as tested by the four methods. There was signiifcant difference between the four methods in the positive rate (P< 0.05). Modiifed acid fast stain was more sensitive than the other 3 methods in identifying tuberculous meningitis (P< 0.05). This method also could identify the intracellularM. tuberculosis. All the 8 samples from the 4 patients who were positive for culture ofM. tuberculosis were positive in the modiifed acid fast stain.Conclusions The modiifed acid fast staining method is simple, fast, signiifcantly more senstive in detection of the acid fastM. tuberculosis in CSF, either extracellular or intracellular. It is worthwhile to further investigate its usefulness in early diagnosis of tuberculosis meningitis.