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Clinical indicators associated with tuberculous meningitis using multiple correspondence analysis.

Xujie Zhu1, Rui Li2, Xiaoxin Zhang2

  • 1Central lab (Genetics lab), Longgang District Maternity & Child Healthcare Hospital of Shenzhen City (Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen 518172, PR China.

Diagnostic Microbiology and Infectious Disease
|June 25, 2025
PubMed
Summary

Early diagnosis of tuberculous meningitis (TBM) is crucial. Clinical indicators like neck stiffness, low serum sodium, and abnormal cerebrospinal fluid (CSF) values can predict microbiologically confirmed TBM in resource-limited settings.

Keywords:
ImmunityMicrobiologicallyNutritionTuberculous meningitis;Cerebrospinal Fluid

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Area of Science:

  • Infectious Diseases
  • Neurology
  • Public Health

Background:

  • Tuberculous meningitis (TBM) is a severe form of tuberculosis with high mortality.
  • Early diagnosis is challenging, especially in resource-limited settings.

Purpose of the Study:

  • To identify clinical indicators for early diagnosis of microbiologically confirmed TBM.
  • To aid clinicians in high-incidence areas with limited diagnostic capacity.

Main Methods:

  • Retrospective cohort analysis of 146 TBM cases.
  • Cerebrospinal fluid (CSF) culture and Xpert testing.
  • Multiple correspondence analysis (MCA) for indicator identification.

Main Results:

  • 80 out of 146 TBM cases were microbiologically confirmed.
  • Key indicators for confirmed TBM include neck stiffness, low serum sodium, low CSF glucose and chloride, and HIV positivity.
  • Hypertension and pulmonary TB were associated with unconfirmed TBM.

Conclusions:

  • Identified clinical indicators can assist in the empirical diagnosis of TBM.
  • Abnormal indicators increase the likelihood of detecting microbial evidence in CSF.