A novel bedside rule-in test for tuberculous meningitis in human immunodeficiency virus-infected adults

• Verfasst von: Broger, Tobias [VerfasserIn]
• Verfasst von: Nicol, Mark P. [VerfasserIn]
• Titel: A novel bedside rule-in test for tuberculous meningitis in human immunodeficiency virus-infected adults
• Verf.angabe: Tobias Broger and Mark P. Nicol
• E-Jahr: 2021
• Jahr: 6 January 2021
• Umfang: 3 S.
• Fussnoten: Gesehen am 22.03.2022
• Titel Quelle: Enthalten in: Clinical infectious diseases
• Ort Quelle: Oxford : Oxford Journals, 1992
• Jahr Quelle: 2021
• Band/Heft Quelle: 73(2021), 9 vom: Nov., Seite e3435-e3437
• ISSN Quelle: 1537-6591
• DOI: doi:10.1093/cid/ciaa1915
• Datenträger: Online-Ressource
• Sprache: eng
• Bibliogr. Hinweis: Ergänzung zu: Quinn, Carson M.: Fujifilm SILVAMP TB LAM assay on cerebrospinal fluid for the detection of tuberculous meningitis in adults with human immunodeficiency virus
• K10plus-PPN: 179626850X

Abstract

(See the Major Article by Quinn et al on pages e3428-34.)Tuberculous meningitis (TBM) likely affects >100 000 people per year [1]. While this represents approximately 1% of all tuberculosis (TB) cases, TBM is disproportionately important because it kills or severely disables half of those affected [2]. Major risk factors for TBM are young age [3] and human immunodeficiency virus (HIV) infection.Diagnosis of TBM is a challenge because clinical features are nonspecific, laboratory tests are insensitive, and mycobacterial culture is too slow to have meaningful clinical impact. Treatment delay is the strongest risk factor for death [2]; sensitive diagnostics with short turnaround times are urgently needed. Rapid nucleic acid amplification tests, such as Xpert MTB/RIF Ultra (Ultra), have shown good sensitivity (77%) against culture-confirmed TBM [4], but require large cerebrospinal fluid (CSF) volumes [5] and are not yet widely available, particularly close to the point of care in many high-burden countries [6].