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外文期刊>Journal of Infection
>Tuberculous meningitis with positive cell-count in lumbar puncture CSF though negative cell-count from ventricular drainage CSF.
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Tuberculous meningitis with positive cell-count in lumbar puncture CSF though negative cell-count from ventricular drainage CSF.
Early diagnosis and treatment is crucial for survival in tuberculous meningitis (TM), an aggressive infection that is fatal or disabling in more than half of those affected. The diagnosis is suggested by clinical assessment and history of tuberculosis exposition and is strongly aided by a chest radiograph positive for tuberculosis.1 The cerebrospinal fluid (CSF) typically shows mononuclear pleocytosis with increased protein and decreased glucose levels. Direct microscopy of the CSF, mycobacterial culture and PCR are the cornerstones of diagnosis. However, both direct examination of CSF and PCR can yield false negative results and culture takes several weeks. Computer tomography (CT) and magnetic resonance imaging (MRI) of the brain could support the diagnosis but are not diagnostic.2 In the current article, a case of TM where diagnosis was postponed due to difficulties in interpreting CSF samples from different compartments is reported. Hopefully this can serve as a pedagogic example of this type of diagnostic pitfalls and thus facilitate correct assessments of similar future cases.
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