To compare CSF adenosine deaminase levels and CSF-PCR for tuberculous meningitis.

Abstract

This study was planned to compare the adenosine deaminase (ADA) levels and polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) as a rapid method to diagnose tuberculosis meningitis (TBM). Fifty-four adult patients with suspected TBM and 37 controls were included in this study. The median ADA level was 21U/L of most likely TBM, 14U/L of unconfirmed TBM and 5U/L of controls. PCR for Mycobacterium tuberculosis was positive in 12 out of 27 most likely TBM cases, 5 out of 27 unconfirmed TBM cases and 3 out of 37 controls. Using a cut off level of >10U/L, CSF-ADA had a sensitivity of 92.5% and specificity of 97% for the diagnosis of TBM. PCR for M. tuberculosis had a sensitivity of 44.5% and specificity 92% in the most likely TBM cases. This study shows that CSF-ADA is a more sensitive indicator than PCR for the diagnosis of M. tuberculosis.

• Authors: S V Rana, F Chacko, V Lal, S K Arora, S Parbhakar, Sanjeev K Sharma, K Singh
• Journal: Clinical neurology and neurosurgery (Clin Neurol Neurosurg) Vol. 112 Issue 5 Pg. 424-30 (Jun 2010) ISSN: 1872-6968 [Electronic] Netherlands
• PMID: 20347212 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2010 Elsevier B.V. All rights reserved.

Chemical References

• DNA Primers
• Adenosine Deaminase

Topics

• Adenosine Deaminase (cerebrospinal fluid, metabolism)
• Adult
• DNA Primers (genetics)
• Female
• Fever (epidemiology)
• Humans
• Male
• Mycobacterium tuberculosis (isolation & purification)
• Polymerase Chain Reaction
• Sensitivity and Specificity
• Time Factors
• Tuberculosis, Meningeal (cerebrospinal fluid, epidemiology, microbiology)