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https://www.readbyqxmd.com/read/28716809/determining-clinical-decision-thresholds-for-hiv-positive-patients-suspected-of-having-tuberculosis
#1
Tom Boyles, Isabella Locatelli, Nicolas Senn, Mark Ebell
Clinical decision thresholds may aid the evaluation of diagnostic tests but have rarely been determined for tuberculosis (TB). We presented clinicians with six web-based clinical scenarios, describing patients with HIV and possible TB at various sites and with a range of clinical stability. The probability of disease was varied randomly and clinicians asked to make treatment decisions; threshold curves and therapeutic thresholds were calculated. Test and treatment thresholds were calculated using Bayes theorem and the diagnostic accuracy of Xpert MTB/RIF...
July 17, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28716254/a-predictive-score-followed-by-nucleic-acid-amplification-for-adult-tuberculous-meningitis-diagnosis-in-southern-brazil
#2
Lívia Maria Pala Anselmo, Cinara Feliciano, Fernando Mauad, Margarida Passeri do Nascimento, Renata Candido Pocente, Jorgete Maria Silva, Valdes Roberto Bollela
From 2012 to 2013, 300 adults under investigation of tuberculous meningitis (TBM) were tested with polymerase chain reaction (PCR) in central spinal fluid (CSF), followed by TBM score calculation. There were 33(11%) confirmed TBM cases based on clinical findings, CSF-culture; biopsy/necropsy exams and clinical improvement after tuberculosis specific treatment. Other 267 adults were classified as non-TBM. Based on the original score there were 143 possible cases (6≤score≤11) and 20(60.6%) out of 33 TBM; among 27 probable TBM (score≥12) there were 13/33 (39...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716226/cytokines-do-play-a-role-in-pathogenesis-of-tuberculous-meningitis-a-prospective-study-from-a-tertiary-care-center-in-india
#3
S Sharma, M K Goyal, K Sharma, M Modi, M Sharma, N Khandelwal, S Prabhakar, N Sharma, Shree R, J Gairolla, A Jain, V Lal
BACKGROUND: Though animal studies have suggested a role for proinflammatory cytokines in pathogenesis their exact role in pathogenesis of human meningeal tuberculosis continues to be controversial with different studies yielding contradictory results. AIM AND OBJECTIVES: To study the levels of proinflammatory cytokines in serum and cerebrospinal fluid (CSF) of patients with tubercular meningitis (TBM) and to determine whether these correlate with disease severity...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716042/tuberculosis-and-hiv-are-the-leading-causes-of-adult-death-in-northwest-ethiopia-evidence-from-verbal-autopsy-data-of-dabat-health-and-demographic-surveillance-system-2007-2013
#4
Yigzaw Kebede, Gashaw Andargie, Abebaw Gebeyehu, Tadesse Awoke, Mezgebu Yitayal, Solomon Mekonnen, Mamo Wubshet, Temesgen Azmeraw, Yihunie Lakew, Kassahun Alemu
BACKGROUND: Reliable data on causes of death form the basis for building evidence on health policy, planning, monitoring, and evaluation. In Ethiopia, the majority of deaths occur at home and civil registration systems are not yet functional. The main objective of verbal autopsy (VA) is to describe the causes of death at the community or population level where civil registration and death certification systems are weak and where most people die at home without having had contact with the health system...
July 17, 2017: Population Health Metrics
https://www.readbyqxmd.com/read/28709486/diagnosis-of-tuberculous-meningitis-current-scenario-from-a-tertiary-neurocare-centre-in-india
#5
Jyothi Embekkat Kaviyil, Raju Ravikumar
BACKGROUND: Tuberculous meningitis (TBM) is a condition that is caused by Mycobacterium tuberculosis complex and is difficult to diagnose due to the nonspecificity of the presentations. The study analyzed the different modes of diagnosis available in a developing country set up over a period of five years to understand the diagnostic values of the current conventional and automated methods of diagnosis of TBM among the patients suspected with chronic meningitis. METHODS: A total of 10,281 cerebrospinal fluid samples (CSF) were collected from suspected chronic meningitis patients, of which 790 samples were from individuals who had clinically suspected TBM...
July 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28692415/whole-genome-sequencing-of-mycobacterium-tuberculosis-isolates-from-extrapulmonary-sites
#6
Kusum Sharma, Renu Verma, Jayshree Advani, Oishi Chatterjee, Hitendra S Solanki, Aman Sharma, Subhash Varma, Manish Modi, Pallab Ray, Kanchan K Mukherjee, Megha Sharma, Mandeed Singh Dhillion, Mrutyunjay Suar, Aditi Chatterjee, Akhilesh Pandey, Thottethodi Subrahmanya Keshava Prasad, Harsha Gowda
Tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. Extrapulmonary tuberculosis (EPTB) constitutes around 15-20% of TB cases in immunocompetent individuals. Extrapulmonary sites that are affected by TB include bones, lymph nodes, meningitis, pleura, and genitourinary tract. Whole genome sequencing has emerged as a powerful tool to map genetic diversity among Mycobacterium tuberculosis (MTB) isolates and identify the genomic signatures associated with drug resistance, pathogenesis, and disease transmission...
July 2017: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/28681808/genotypic-characterisation-of-mycobacterium-tuberculosis-isolates-from-tuberculous-meningitis-patients-at-a-tertiary-neurocare-centre-in-southern-india
#7
Akepati Chandramuki, Neelam Khanna, Elena Shashkina, Natalia Kurepina, Barun Mathema, Barry N Kreiswirth, Manjunatha M Venkataswamy
AIMS: Specific genotypes of Mycobacterium tuberculosis (MTB) have been reported to cause outbreaks of pulmonary tuberculosis (TB) in geographical areas that are endemic to TB. However, since there is little epidemiological evidence on the association of particular genotypes that cause tuberculous meningitis (TBM), we sought to investigate the association of specific MTB strains with infection of the central nervous system (CNS). MATERIALS AND METHODS: We carried out a genetic characterisation of 89 MTB isolates from TBM patients at a Southern Indian tertiary neurocare centre and compared the genotypes with strains of pulmonary TB isolated from Indian immigrants in New York City...
April 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28678217/choroid-plexus-tuberculoma-diagnosis-management-and-role-of-endoscopy
#8
Nishanth Sadashiva, Bevinahalli N Nandeesh, Dhaval Shukla, Bhagavatula I Devi
Ventricular involvement in central nervous system tuberculosis can be in the form of tuberculous ependymitis, intraventricular tuberculoma, intraventricular tuberculous abscess, choroid plexitis and choroid plexus tuberculoma. Only a few cases of choroid plexus tuberculomas have been described and even more rare is the description of the role of endoscopy in management of intraventricular tuberculomas. We report a 33-year-old patient while on treatment for tubercular meningitis who developed a left side choroid plexus lesion with loculated temporal horn...
July 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/28659187/tuberculous-meningoencephalitis-associated-with-brain-tuberculomas-during-pregnancy-a-case-report
#9
Sadie Namani, Shemsedin Dreshaj, Arieta Zogaj Berisha
BACKGROUND: Tuberculous meningitis is globally highly prevalent and is commoner in resource-limited countries and in patients with immunosuppression. Central nervous system tuberculosis is one of the severest forms of extrapulmonary tuberculosis during pregnancy and associated brain tuberculomas have been rarely reported. With the availability of neuroimaging at our hospital center, we present the first case of tuberculous meningoencephalitis associated with brain tuberculomas during pregnancy...
June 29, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28658161/old-age-and-hydrocephalus-are-associated-with-poor-prognosis-in-patients-with-tuberculous-meningitis-a-retrospective-study-in-a-chinese-adult-population
#10
Hai-Jun Huang, Ze-Ze Ren, Yi-Ning Dai, Yong-Xi Tong, Dan-Hong Yang, Mei-Juan Chen, Yi-Cheng Huang, Ming-Shan Wang, Jia-Jie Zhang, Wen-Yuan Song, Hong-Ying Pan
Tuberculous meningitis (TBM) is the most common form of central nervous system tuberculosis with a very poor prognosis. We aimed at assessing risk factors related to the prognosis of patients with TBM.Forty-five inpatients with TBM in our institution from January 2013 to December 2015 were enrolled retrospectively. The good or poor prognosis in the patients was defined, based on Glasgow Outcome Scale System at discharge. Patients with a GOS score less than 5 were defined as "poor prognosis." Univariate and multivariate logistic regression analyses were performed to assess the predictors for TBM outcome...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638662/comparison-of-dna-extraction-protocols-and-molecular-targets-to-diagnose-tuberculous-meningitis
#11
Flavia Silva Palomo, Martha Gabriela Celle Rivero, Milene Gonçalves Quiles, Fernando Pereira Pinto, Antonia Maria de Oliveira Machado, Antonio Carlos Campos Pignatari
Tuberculous meningitis (TBM) is a severe form of extrapulmonary tuberculosis. The aims of this study were to evaluate in-house molecular diagnostic protocols of DNA extraction directly from CSF samples and the targets amplified by qPCR as an accurate and fast diagnosis of TBM. One hundred CSF samples from 68 patients suspected of TBM were studied. Four DNA extraction techniques (phenol-chloroform-thiocyanate guanidine, silica thiocyanate guanidine, resin, and resin with ethanol) were compared and CSF samples were used to determine the best target (IS6110, MPB64, and hsp65 KDa) by qPCR...
2017: Tuberculosis Research and Treatment
https://www.readbyqxmd.com/read/28605426/biomarkers-of-cerebral-injury-and-inflammation-in-pediatric-tuberculous-meningitis
#12
Ursula K Rohlwink, Katya Mauff, Katalin A Wilkinson, Nico Enslin, Emmanuel Wegoye, Robert J Wilkinson, Anthony A Figaji
Background: Tuberculous meningitis (TBM) leads to death or disability in half the affected individuals. Tools to assess severity and predict outcome are lacking. Neuro-specific biomarkers could serve as markers of the severity and evolution of brain injury, but have not been widely explored in TBM. We examined biomarkers of neurological injury (neuromarkers) and inflammation in pediatric TBM and their association with outcome. Methods: Blood and cerebrospinal fluid (CSF) of children with TBM and hydrocephalus taken on admission and over 3 weeks were analysed for neuromarkers S100B, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), and multiple inflammatory markers...
June 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28594104/the-risk-factor-of-false-negative-and-false-positive-for-t-spot-tb-in-active-tuberculosis
#13
Li Di, Yan Li
OBJECTIVES: T-SPOT.TB is a promising diagnosis tool to identify both pulmonary tuberculosis and extrapulmonary tuberculosis, as well as latent tuberculosis; however, the factors that affect the results of T-SPOT.TB remains unclear. In this study, we aim to figure out the risk factor of T-SPOT.TB for active TB. METHODS: A total of 349 patients were recruited between January 1st, 2016 and January 22st, 2017 at Renmin Hospital of Wuhan University, including 98 subjects with TB and 251 subjects with non-TB disease, and received T-SPOT...
June 8, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28589071/a-case-report-on-complicated-tuberculous-meningitis
#14
Nadia Jawad, Saira Jafri, Syeda Naqvi, Syed Masroor Ahmad, Shabnam Naveed, Zeeshan Ali
Tuberculous meningitis (TBM) is associated with significant complications of central nervous system. It is accompanied by nonspecific and heterogeneous clinical symptoms. We focused on the significance of early diagnosis and prompt treatment. We describe a case of TBM in a 19-year-old Asian female. She had a progressive motor weakness with no sensory findings. She was started on antituberculous therapy. Her magnetic resonance imaging (MRI) contrast of dorsolumbar spine showed syringomyelia. Her culture and sensitivity for Mycobacterium tuberculosis (MTB) came negative...
May 4, 2017: Curēus
https://www.readbyqxmd.com/read/28571185/determination-and-validation-of-a-lower-cut-off-value-of-cerebrospinal-fluid-adenosine-deaminase-csf-ada-activity-in-diagnosis-of-tuberculous-meningitis
#15
Raviraj, Renoy A Henry, G Ganapathi Rao
INTRODUCTION: Tuberculous meningitis is an infection of the meninges caused by Mycobacterium tuberculosis. It is one of the most common infectious diseases of the Central Nervous System (CNS) and a major health problem in developing countries like India. If there is delay in diagnosis and initiation of specific treatment, it causes significant morbidity and mortality. CSF-ADA 10 U/l is the standard cut off value that is used for differentiation between Tuberculous (TBM) and Non-Tuberculous Meningitis (non-TBM)...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28571129/comparative-diagnostic-utility-of-is6110-pcr-assay-in-csf-and-peripheral-blood-samples-of-tuberculous-meningitis-patients-a-pilot-study-from-central-india
#16
Sonali D Manke, Aliabbas A Husain, Hatim F Daginawala, Lokendra K Singh, Rajpal S Kashyap
INTRODUCTION: Tuberculous Meningitis (TBM) is the most severe form of Central Nervous System Tuberculosis (CNS-TB) and constitutes about 6% of all Extrapulmonary TB (EPTB) cases. Most guidelines for the diagnosis and management of TBM agree on the use of simple Cerebrospinal Fluid (CSF) analysis using molecular tools like Polymerase Chain Reaction (PCR). However, the sensitivity of PCR varies while using a CSF sample. In the present study, we have compared the diagnostic utility of PCR assay in both peripheral blood and CSF sample collected from TBM cases...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28559518/epidemiology-of-extrapulmonary-and-disseminated-tuberculosis-in-a-tertiary-care-center-in-oman
#17
Zied Gaifer
BACKGROUND: The incidence of extrapulmonary and disseminated tuberculosis (TB) cases is increasing worldwide, and this growth significantly impacts TB-related morbidity and mortality. Little is known about the host risk factors for extrapulmonary and disseminated TB. In this study, we examined those risk factors. MATERIALS AND METHODS: We conducted a retrospective review of all TB cases admitted to Sultan Qaboos University Hospital from 2006 to 2015. We compared extrapulmonary TB (EPTB) cases with pulmonary and disseminated TB cases...
April 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28559513/extrapulmonary-tuberculosis-in-colombian-children-epidemiological-and-clinical-data-in-a-reference-hospital
#18
Eileen Viviana Fonseca Sepulveda, Luisa Fernanda Imbachí Yunda, Kelly Christina Márquez Herrera, German Camacho Moreno
BACKGROUND: The pediatric population is at increased risk of disseminated and extrapulmonary tuberculosis (TB). There is little information on children affected by this entity. The demographic, clinical, and outcome characteristics of the treatment of children with extrapulmonary TB, treated at a national reference institution between January 1, 2008, and December 31, 2016, are described and analyzed in this work. MATERIALS AND METHODS: This was a retrospective observational study...
April 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28544969/prior-treatment-with-non-anti-tb-antibiotics-and-the-duration-of-symptoms-have-no-effect-on-diagnostics-of-tuberculous-meningitis
#19
Marcin Paciorek, Andrzej Pihowicz, Dominik Bursa, Joanna Schöntaler Humięcka, Justyna D Kowalska, Mateusz Antosiewicz, Magda E Thompson, Agata Skrzat-Wojdacz, Agnieszka Bednarska, Andrzej Horban
PURPOSE: Our objective was to investigate whether diagnosis of tuberculous meningitis (TBM) with microbiological and molecular analysis was affected by prior empirical non anti tuberculosis antibiotics or by duration of symptoms before lumbar puncture. MATERIALS AND METHODS: We retrospectively evaluated medical records of patients with TBM confirmed by positive culture, nucleic acid amplification techniques (NAATs) or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) or by characteristic results of biochemical analysis of CSF combined with a typical clinical manifestation...
May 22, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28501491/diagnostic-usefulness-of-xpert-mtb-rif-assay-for-detection-of-tuberculous-meningitis-using-cerebrospinal-fluid
#20
Syed Beenish Rufai, Amit Singh, Jitendra Singh, Parveen Kumar, Manimuthu Mani Sankar, Sarman Singh
OBJECTIVE: Tuberculous meningitis (TBM) is the most severe form of extra-pulmonary tuberculosis (TB) due to association of diseases with high rates of mortality and morbidity. Diagnosis continues to be a clinical challenge as microbiological confirmation is rare and time consuming resulting in delayed treatment. Xpert MTB/RIF assay is a rapid and simple test, which has been endorsed by World Health Organization as an initial diagnostic test for the diagnosis of TBM. However, evidence still lacks for its performance on cerebrospinal fluid (CSF) for the diagnosis of TBM especially from India...
August 2017: Journal of Infection
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