![]() ![]() Isopropanol and resuspended in 50 µl of distilled water, andĪ 10 µl aliquot was used for PCR amplification (100 ng ofĭNA for the test), as previously described ( 15). Using the phenol-chloroform method, as previously described The strains were grown in MiddlebrookħH9 broth (Difco, Franklin Lakes, NJ, USA) and DNA was isolated (clinical isolate given by Dr Ruth Parra of the National MedicalĬenter, Mexico City, Mexico). Habana (clinical isolates previously identified by rRNA 16S tuberculosis H37Rv (donated by The Pasteur Institute, The mycobacterial strains used as controls were Patients and methods Bacterial strains and DNA isolation Identify TB in cases of meningitis with clinical and laboratoryĮvidence suggestive of TBM, and to confirm our findings with Identification of the genus of the tuberculosis complex, but does However, the reported methods areīased primarily on primers that bind IS 6110, which allow the The CSF of patients with TBM, with varying sensitivity and Of PCR and quantitative PCR to identify M. Tuberculosis complex, and are useful in differentiating theseįrom non-tuberculous mycobacteria ( 22– 25). Specifically characterize different species of the M. ( 20, 21) have identified major deletions that tuberculosis ( 19) and studies on comparative genomics May identify a wide variety of microorganisms, including PCR for amplification of genes specific for the infecting organism Molecular tests, in particular those based on the Radiological tests, responses to treatment and in the Its diagnosis is currently based on clinical characteristics, Non-specific, similar to those of other forms of meningitis, suchĪs neurocysticercosis, neuroborreliosis, or viral infections thus, Staining of CSF difficult, as the results are usually negative.įurthermore, the clinical manifestations of TBM are often In infections of theĬentral nervous system, such as TBM, the bacterial load isĮxtremely low, thus making diagnoses based on the culture or In order to improve the clinical outcome. ![]() Severity of TBM demands a rapid diagnosis and appropriate treatment tuberculosis in theĬerebrospinal fluid (CSF) of patients with TBM. The conventional 'gold standard'īacteriological methods, namely direct smear and culture isolation,Īre hardly able to detect M. Left untreated, the mortality associated with TBM is almost 100%Īnd delayed treatment may lead to permanent neurological damage Meningitis (TBM) is the most severe form of the infection, which is Extra-pulmonary tuberculosis resultsįrom bacterial spread to other sites in the body, and occurs inĪpproximately 10% of patients hospitalized with pulmonary The two main presentations of tuberculosis are Nations, tuberculosis is ranked 17th among the leading causes ofĪll deaths in the working-aged general population ( 4). WHO reported a prevalence of 370 tuberculosisĬases per 100,000 individuals in the United States ( 3). Million new cases and 1.1 million human immunodeficiency virus The species responsible for most of these deaths ( 1, 2).Īccording to the World Health Organization (WHO), in 2014, theĮstimated number of tuberculosis cases was 9 million, including 3.5 Infectious causes of death in developing nations, with Tuberculosis (TB) remains among the leading ![]() The use CSF for the analyses proved to be effective for the rapid diagnosis of TBM using a developed system of multiplex and nested PCR analyses in patients presenting neurological symptoms. The analysis exhibited a sensitivity of 98.0%, a specificity of 92.0%, a positive predictive value of 88.0% and a negative predictive value of 98.0%. TB infection was confirmed with molecular tests in 49 patients from the 50 cases suggestive of TBM and in 1 of the 50 non-TBM cases. Nested PCR detected 0.1 fg of M. tuberculosis DNA. Cerebrospinal fluid (CSF) was collected from all 100 patients (cases and controls) and tested for TB by multiplex and nested PCR analyses. ![]() As the controls, we included 50 cases of meningitis with clinical and laboratory evidence suggestive of non-TBM. A total of 144 consecutive patients with suggestive infectious meningitis were initially included 94 cases of meningitis with clinical and laboratory evidence suggestive of TBM were included, but only 50 of these cases fulfilled the criteria for probable TBM. We recruited patients with neurological symptoms who were examined at the neurology services of Hospitals of Instituto Mexicano del Seguro Social (IMSS) in Mexico City. The aim of this study was to identify tuberculosis (TB) in cases of meningitis with clinical and laboratory evidence suggestive of TBM, and to confirm our findings with molecular tests for TB infection. The symptoms are similar to other infectious neurological diseases, such as neurocysticercosis, neuroborreliosis, or herpes viral infection. It is caused by Mycobacterium tuberculosis (M. tuberculosis MT) and it is very difficult to diagnose. Tuberculous meningitis (TBM) is the most severe form of tuberculosis. ![]()
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