The neurochemical markers in cerebrospinal fluid to differentiate between aseptic and tuberculous meningitis (original) (raw)
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Eastern Journal Of Medicine
In our study, we aimed to detect amino acid changes, if any, by comparing the levels of amino acids in cerebrospinal fluid (CSF) samples of patients with aseptic, bacterial, and tuberculous meningitis and control groups. Patients diagnosed with aseptic meningitis (n=41), tuberculous meningi tis (n=21), bacterial meningitis (n=41) and a control group consisting of 64 individuals with similar gender and age characteristics were included in the study. 2 mL of cerebrospinal fluid specimens were obtained from all patients and control group and sto red at-80 °C until the study day. The amino acid measurements were performed using commercially available liquid chromatography-tandem mass spectrometry method (LC-MS / MS) kits. When we investigated amino acids levels in all groups, the levels of 1-methyl histidine, alanine, asparagine, histidine, isoleucine, lysine, methionine, norvaline, ornithine, phenylalanine, proline, sarcosine, threonine, tyrosine, valine in the aseptic, tuberculosis and bacterial meningitis groups were statistically higher than t hose of the control group. The levels of all amino acids except cystine, glutamic acid, homo-citrulline, and taurine in the patients with aseptic meningitis were statistically significantly higher than in the control group. The levels of all amino acids ex cept homocitrulline, and tryptophan were statistically significantly higher in the patient group with tuberculous meningitis than in the control group. The levels of all amino acids except glutamic acid were statistically significantly higher in the patient group with bacterial meningitis than in the control group.
Analysis of Cerebrospinal Fluid Analytes in Bacterial and Tuberculous Meningitis
2018
Objective: Meningitis is the severe and lethal infection spread worldwide. The most common forms of meningitis are viral and bacterial meningitis caused by Neisseria meningitides and other species. Tuberculous meningitis (TBM) is the most mortal form of Mycobacterium tuberculosis infection, which has a high rate of neurological complications and sequelae. The best method for diagnosis of meningitis is cerebrospinal fluid analysis (CSF). The purpose of present study is to determine the CSF examination (glucose and protein levels) of subjects with bacterial meningitis (BM) and TBM and their comparison with healthy individuals. Study Design: Cohort Study. Place and Duration of study: The study was conducted in Children Medical Complex Hospital Multan, during February 2016 to June 2016. Materials and Methods: The data of 75 children (25 of TBM, 25 of BM and 25 of normal) with age <5 years was collected. The analysis of CSF protein and glucose levels was done by standard methods. The...
Rapid diagnosis of tuberculous meningitis by polymerase chain reaction assay of cerebrospinal fluid
Journal of Neurology, 1995
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Clinical and Cerebrospinal Fluid Abnormalities as Diagnostic Tools of Tuberculous Meningitis
Althea Medical Journal, 2016
Background : Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculous (TB) disease and remains difficult to diagnose. The aim of the study was to determine the diagnostic value of clinical and laboratory findings of cerebrospinal fluid (CSF) examinations for diagnosing TBM using bacterial culture result as the gold standard. Methods : A prospective cross sectional study was carried out to 121 medical records of hospitalized TBM patients in neurological ward at Dr. Hasan Sadikin General Hospital Bandung, from 1 January 2009–31 May 2013. The inclusion criteria were medical records consisted of clinical manisfestations and laboratory findings. The clinical manisfestations were headache and nuchal rigidity, whereas the laboratory findings were CSF chemical analysis (protein, glucose, and cells) and CSF microbiological culture. Validity such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for clinical and laboratory ...
Comparison of clinical and CSF profiles in 62 Adults with tuberculous and pyogenic meningitis
International Journal of Research in Medical Sciences, 2017
Background: Many a times differentiating tuberculous meningitis from pyogenic meningitis becomes very difficult. The diagnosis depends upon clinical manifestation and cytochemical analysis of cerebrospinal fluid (CSF). Many researchers found that the CSF glucose: protein ratio less than 0.5 and Adenosine deaminase levels (ADA) in cerebrospinal fluid are useful to differentiate tubercular disease from non-tubercular meningitis.Methods: Sixty-two patients admitted to our tertiary hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular (n=39) and pyogenic (n= 23), depending upon the accepted criteria. Clinical features and CSF parameters noted in each patient. Cut off value of ADA kept at or above 10 IU/L for tubercular meningitis.Results: The mean age of patients with tubercular meningitis was 39.07±16.67 years and that of pyogenic meningitis 34.35±16.73 years. Clinically fever was present in 60 (96.77%), headache in 49 (79.03%), and vomiti...
Role of Cerebrospinal fluid Lactate Dehydrogenase in meningitis
Background: Meningitis still remains a condition of significant mortality and morbidity in pediatric practice. Tubercular and bacterial meningitis form an important group of neurological diseases associated with considerable mortality and morbidity in children. Material and Methods: The present study was carried out in the Department of Biochemistry at Government Medical College and Hospital, Aurangabad during the period June 1999 to June 2001 on 40 patients of meningitis and 20 controls from pediatric age group. CSF and blood samples from patients suffering from pyogenic meningitis (32) (Group II), tuberculous meningitis (Group III) (8) and control subjects (Group I) (20) were examined. Statistical analysis was done by One way ANOVA non-parametric test with Tukey-test to compare all the group was used and calculated by SPSS 19 version of the software. Result: In our study we have seen that CSF sugar was Significantly lower in the Pyogenic Meningitis Group (II) as compared to Controls (I) and Tuberculous meningitis (III) group (p<0.05) and also CSF/Blood Sugar Ratio was significantly lower Pyogenic (II) and Tuberculous (III) Meningitis group as compared to Control (I) (p<0.05) but were comparable to each other in the group (II and III) (p>0.05). CSF Proteins were significantly higher in Pyogenic (II) and Tuberculous Meningitis group (III) as compared to controls (p<0.05) but comparable with each other (II vs III) (p>0.05). In present study: Mean CSF LDH value of meningitis (total) was significantly increased (P<0.05) as compared to controls. Mean CSF LDH value in meningitis (total) was 87.42±28 IU/L as compared to 26.85±10.79 IU/L in controls. Conclusion: We have concluded that LDH help the clinician for diagnosing meningitis in addition to the routine investigations, further LDH may help in the differentiation between pyogenic and tuberculous meningitis.
Serum sodium and osmolal changes in tuberculous meningitis
Indian pediatrics, 1994
Twenty children from 2 months to 7 years (mean age 2.74 years +/- 1.62) diagnosed to have tuberculous meningitis (TBM) were evaluated for serial serum sodium levels and osmolality of cerebrospinal fluid (CSF), serum and urine on admission and the results compared with 20 age and nutritionally matched controls, and these investigations repeated on day 3 and day 10. Mean serum sodium levels (130.7 +/- 6.26 mEq/L), and osmolality of CSF (272.0 +/- 7.0 mOsm/kg) and serum (275.5 +/- 6.09 mOsm/kg) were significantly lower (p < 0.001) than in controls. Hyponatremia was detected in 65% of cases on admission, 47% on day 3 and in 30.8% on day 10. All the patients with hyponatremia had biochemical evidence of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) on admission. Incidence of SIADH gradually decreased to 41.2% on day 3 and 15.4% on day 10. In some of the cases serum sodium levels and osmolality of serum and CSF took about 3 weeks to return to normal. CSF osmolalit...
Cerebrospinal Fluid Cytokines in Patients with Tuberculous Meningitis
Clinical Immunology and Immunopathology, 1997
The levels of tumor necrosis factor (TNF)-a, soluble tion in patients with a more severe form of tuberculosis, TNF receptors p75 (sTNFR-75) and sTNFR-55, intersuch as tuberculous meningitis (TBM). To gain insight feron (IFN)-g, and interleukin (IL)-10 and IL-12 were into the role that cytokines play in the tuberculous measured in 59 cerebrospinal fluid (CSF) samples from infection of the central nervous system (CNS), we eval-15 patients with tuberculous meningitis (TBM). TBM uated cerebrospinal fluid (CSF) concentrations of tuwas associated with elevated concentrations of TNFmor necrosis factor (TNF)-a, soluble TNF receptors p75 a, sTNFR-75, sTNFR-55, IFN-g, and IL-10, while CSF IL-(sTNFR-75) and sTNFR-55, IFN-g, and interleukin 12 was undetectable in all TBM patients. A significant (IL)-10 and IL-12 in patients with TBM. The kinetics correlation between cytokines and CSF adenosine deof these cytokines during the course of the disease was aminase activity was also found. The levels of TNF-a also investigated in most patients. did not decrease over time, being still detectable in the CSF 16 months after starting antibiotic therapy, MATERIALS AND METHODS whereas IFN-g along with anti-inflammatory mediators sTNFR-75, sTNFR-55, and IL-10 remained elevated Subjects in the CSF for 4-8 months. The chronic release of cytokines in the CSF compartment was related neither to The patient population consisted of 15 patients with the TBM stage nor to the clinical outcome of the dis-TBM, admitted to the Department of Infectious and ease, thus suggesting the presence of a continuous ac-Tropical Diseases of La Sapienza University of Rome, tivity of the inflammatory process at the site of infec-Italy. All patients had a history and clinical findings tion. ᭧ 1997 Academic Press compatible with the diagnosis of TBM. For six cases, the diagnosis was confirmed by isolation of M. tuberculosis from CSF. In the remaining 9 patients, diagnosis