GeneXpert: A Rapid and Supplementary Diagnostic Tool for Tuberculous Meningitis, Experience from Tertiary Neurocenter.
Priyanka WakodeNagarathna SiddaiahNetravathi ManjunathVeena Kumari Haradara BahubaliPublished in: Journal of neurosciences in rural practice (2022)
Background Tuberculous meningitis (TBM) is a highly lethal form of central nervous system tuberculosis (CNS TB) that causes high mortality and morbidity in children and adults. Nonspecific clinical presentation and fewer TB bacilli challenge clinicians resulting in delays in diagnosis and treatment. Aim This study aimed to evaluate the utility of GeneXpert alone and in combination with culture using 1 mL of cerebrospinal fluid (CSF) in a volume constraint situation. Methods A total of 125 clinically confirmed TBM and 110 non-TBM cases, comprised of both infectious and noninfectious diseases. were included in the study. Patient details including clinical signs and symptoms, CSF, and imaging data were collected from the case records. CSF samples were obtained from all the patients and were tested by the mycobacterial culture method and GeneXpert test. The performance of both the tests was statistically calculated and reported in the form of sensitivity and specificity. Results Out of 125 TBM cases, 40 were detected positive by culture and 26 by GeneXpert. All 110 non-TBM cases were identified negative by both methods. The sensitivity and specificity of GeneXpert in comparison with culture were 27 and 100%, respectively. The culture was found to be more sensitive (32%) than GeneXpert. But the assay was able to detect a considerable number of clinically confirmed culture-negative TBM cases. Conclusion GeneXpert is a rapid test and including this as an adjunctive test along with the culture in routine clinical practice can improve the diagnosis of TBM in volume constraint scenario.
Keyphrases
- cerebrospinal fluid
- mycobacterium tuberculosis
- clinical practice
- end stage renal disease
- chronic kidney disease
- high resolution
- type diabetes
- emergency department
- prognostic factors
- mass spectrometry
- ejection fraction
- cardiovascular disease
- young adults
- depressive symptoms
- peritoneal dialysis
- coronary artery disease
- machine learning
- palliative care
- photodynamic therapy
- hepatitis c virus
- single cell
- multidrug resistant
- sleep quality