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Polymerase chain reaction in the diagnosis of tuberculous meningitis
P R Donald1, T C Victor, A M Jordaan
1Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg, Republic of South Africa.
Abstract:
43 cerebrospinal fluid (CSF) specimens obtained from 20 children with tuberculous meningitis (TBM) at varying times during the first month of treatment were examined by polymerase chain reaction (PCR) for the presence of M. tuberculosis DNA. Overall 27 CSF specimens (63%) from 16 patients (80%) gave > or = 1 positive results and positive results were obtained from CSF specimens throughout the first 4 weeks of therapy. Nine CSF specimens (21%) gave a doubtful result (only 1 of duplicate determinations positive) and 7 (16%) a negative result. CSF from patients with suspected TBM should be submitted for PCR evaluation and positive results may be obtained up to at least 4 weeks after the start of treatment.
Insights
Polymerase chain reaction (PCR) detected Mycobacterium tuberculosis DNA in 63% of cerebrospinal fluid samples from children with tuberculous meningitis (TBM) up to four weeks into treatment.
Area of Science:
- Microbiology
- Infectious Diseases
- Pediatrics
Background:
- Tuberculous meningitis (TBM) is a severe infection requiring prompt diagnosis and treatment.
- Early detection of M. tuberculosis in cerebrospinal fluid (CSF) is crucial for effective management.
- Polymerase chain reaction (PCR) offers a sensitive method for identifying microbial DNA.
Purpose of the Study:
- To evaluate the utility of PCR for detecting M. tuberculosis DNA in CSF of children with TBM.
- To determine the duration for which M. tuberculosis DNA remains detectable in CSF during early treatment.
Main Methods:
- Analysis of 43 CSF specimens from 20 children diagnosed with TBM.
- Utilized polymerase chain reaction (PCR) to detect M. tuberculosis DNA.
- Specimens were collected at various time points during the first month of anti-TB therapy.
Main Results:
- Overall, 63% of CSF specimens (27/43) from 80% of patients (16/20) yielded positive PCR results.
- Positive PCR results were consistently observed throughout the first four weeks of treatment.
- Doubtful and negative results were obtained in 21% and 16% of specimens, respectively.
Conclusions:
- PCR is a valuable tool for diagnosing TBM in pediatric patients.
- Detectability of M. tuberculosis DNA in CSF persists for at least four weeks into treatment.
- CSF PCR evaluation should be considered for suspected cases of TBM.