A study on differentiation of tubercular meningitis from acute bacterial meningitis using simple clinical and laboratory parameters along with CBNAAT
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2188-2194
AbstractIntroduction: Meningitis is a serious infection of the meninges, the membranes covering the brain and spinal cord. It is a devastating disease and remains a major public health challenge. Acute bacterial meningitis (ABM) remains a serious global health threat with high mortality and morbidity, despite advances in antibiotic therapy and modern vaccination strategies. Tuberculosis (TB) remains the major cause of ill health, one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent.
Methods and Methodology: A hospital-based simple prospective observational study was carried out among 56 cases, between the age groups 2 months to 14 years, who fit into clinical diagnosis of bacterial meningitis.
Results: A total of 56 cases of meningitis were included &analyzed for the study. Mean CSF cell count was significantly higher in ABM group as compared to TBM (374.67±252.55 vs 175±78.64). Lymphocyte predominance is seen in all the TBM cases and Neutrophils predominance is seen in majority of ABM cases (p<0.05). CSF ADA >8 is seen significantly in all the TBM cases compared to ABM cases (p<0.05). CSF CBNAAT was positive significantly in TBM cases compared to ABM (p<0.05). Mean CSF protein count was significantly higher in TBM group as compared to ABM (219.4±55.64 vs 108.44±33.04).
Conclusion: CBNAAT should be used in preference to conventional methods as the initial diagnostic test for patients suspected of having TB. CBNAAT positivity shows significant association with positive Mantoux test and CSF analysis suggestive of TBM.
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