Free Content Rapid diagnosis of Mycobacterium tuberculosis meningitis by enumeration of cerebrospinal fluid antigen-specific T-cells

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SETTING: Hospital in-patients with suspected tuberculous meningitis (TBM), predominantly in India.

OBJECTIVE: To determine whether interferon-gamma (IFN-) secreting Mycobacterium tuberculosis antigen-specific T-cells are present in the cerebrospinal fluid (CSF) of patients with TBM and to evaluate the feasibility of CSF enzyme-linked immunospot (ELISpot) for the diagnosis of active TBM.

DESIGN: Prospective blinded hospital-based study.

RESULTS: The overnight ELISpot assay detected M. tuberculosis antigen-specific IFN- secreting T-cells in CSF from nine of 10 prospectively recruited patients with TBM, and zero of seven control patients with meningitis of other aetiology. This corresponds to a diagnostic sensitivity of 90% (95%CI 56–100) and specificity of 100% (95%CI 59–100).

CONCLUSION: This pilot study demonstrates proof-of-principle for a new T-cell-based diagnostic test for TBM which is rapid, sensitive and specific.

Keywords: diagnosis; meningitis; sensitivity; specificity; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Neurology, Christian Medical College, Vellore, India 2: Tuberculosis Immunology Group, Centre for Respiratory Infection, National Heart and Lung Institute, Imperial College, London, UK 3: Department of Nephrology, Christian Medical College, Vellore, India 4: Department of Geriatrics, Evangelisches Krankenhaus, Göttingen-Weende, Germany 5: Medical Clinic, Research Centre, Borstel, Germany 6: Institut für Hygiene, Klinikum Krefeld, Krefeld, Germany 7: Department of Respiratory Medicine, Southampton General Hospital, Southampton, UK

Publication date: June 1, 2008

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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