%0 Journal Article
%T Evaluation of the IS6110 PCR assay for the rapid diagnosis of tuberculous meningitis
%A Poonam S Deshpande
%A Rajpal S Kashyap
%A Sonali S Ramteke
%A Khushboo J Nagdev
%A Hemant J Purohit
%A Girdhar M Taori
%A Hatim F Daginawala
%J Fluids and Barriers of the CNS
%D 2007
%I BioMed Central
%R 10.1186/1743-8454-4-10
%X An in-house IS6110 PCR method using a specific pair of primers designed to amplify the insertion sequence, IS6110, in the M. tuberculosis genome was used to analyze CSF. A total of 80 CSF samples from different groups of patients were studied (confirmed TBM n = 35, clinically suspected TBM n = 16, non-TBM infectious meningitis n = 12, non infectious neurological diseases n = 17).PCR gave a sensitivity of 91.4% and specificity of 75.9% for the diagnosis of TBM in patients with TBM confirmed by culture. In 16 clinically diagnosed, but unconfirmed, TBM cases PCR was positive in 10 (62.5%) cases. There were seven (24.1%) PCR-positive cases among the 29 patients with non-TBM and non-infectious neurological disease.We conclude that the performance of an in-house IS6110 PCR assay is valuable in the rapid diagnosis of tuberculous meningitis.Tuberculosis (TB) is one of the major causes of morbidity and mortality worldwide. India has about 1.8 million new cases of TB annually, accounting for a fifth of new cases in the world ¨C a greater number than in any other country [1]. Among, extra-pulmonary TB, tuberculous meningitis (TBM) leads to multiple central nervous system (CNS) complications and remains a major health problem in underdeveloped and developing countries [2]. Delayed treatment of TBM is associated with high mortality and with neurological problems, which underscores the importance for early diagnosis [3].Confirming the clinical suspicion of TBM has always been problematic. Acid-fast bacilli (AFB) staining of cerebrospinal fluid (CSF) has a very low sensitivity [4]. Although conventional bacterial culture is the gold standard for diagnosis, the inherent time limitation of the culture-based test, limits its value [5,6]. The culture of M. tuberculosis from CSF takes 4¨C6 weeks and leads to a delay in diagnosis [7,8]. Analysis of CSF using antibody detection is suggestive but not diagnostic of TBM [9]. In the absence of any reliable diagnostic methods, various immunolog
%U http://www.fluidsbarrierscns.com/content/4/1/10