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Tuberculin reactivity in tuberculous meningitis.
B Mahadevan1, S Mahadevan, V Tiroumourougane Serane
1Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. smaha1232@rediffmail.com
Indian Journal of Pediatrics
|April 7, 2005
Summary
Tuberculin skin test positivity is low in childhood tuberculous meningitis (TBM). Histopathology reveals inflammatory responses even in tuberculin-negative cases, indicating subclinical reactivity.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Childhood tuberculous meningitis (TBM) poses diagnostic challenges.
- Assessing cell-mediated immunity in TBM is crucial for understanding disease progression.
Purpose of the Study:
- To investigate tuberculin reactivity in children with TBM.
- To correlate clinical and histopathological findings of tuberculin tests.
Main Methods:
- Tuberculin test (Mantoux technique) administered to children with TBM.
- Skin test sites examined clinically and histopathologically after 72 hours.
- Histopathological grading compared with clinical parameters.
Main Results:
- Tuberculin test positivity was 44% in 50 children studied.
- Malnutrition (68%) and BCG scar (42%) were common.
- No correlation found between BCG status and tuberculin reaction size.
- Negative correlation between TBM stage and tuberculin reaction size.
Conclusions:
- Tuberculin positivity is low in TBM, independent of nutritional status.
- Histopathology demonstrates inflammatory reactions at the test site, even in clinically negative cases.
- Subclinical cellular responses to tuberculin can be detected histopathologically in TBM.