The Relationship between Characteristics of Cerebospinal Fluid and Tuberculous Meningitis detected using Real Time PCR
ABSTRACT: Tuberculosis (TB)
carries a high morbidity and mortality, however, its diagnosis can be difficult
due to low concentration of bacteria in the cerebrospinal fluid (CSF). Although
increased CSF protein, decreased CSF glucose; cerebrospinal fluid (CSF)
pleocytosis with mononuclear cells predominance are commonly used to diagnose
TB infection, they show inconsistent results. Objectives: To analyze the relationship
between several characteristics of the CSF and TB meningitis. Methods: This is
an observational research, with a cross sectional design, 27 patients with TB
meningitis and or meningoencephalitis with Thwaites diagnostic score ≤ 4
obtained from mecidal records. The definitive diagnosis of TB meningitis was
made using the Ziehl Neelsen (ZN) staining and or culture TB, or polymerase
chain reaction (PCR) amplification with the target in IS6110, Ziehl-Neelsen
staining (ZN) culture method. Characteristics of CSF including increased CSF
protein, decreased CSF glucose, cerebrospinal fluid (CSF) pleocytosis with
mononuclear cells predominance and the CSF abnormalities were evaluated in the
laboratory of molecular microbiology of Medical Faculty, Diponegoro
University/dr Kariadi General Hospital, Semarang. The statistical analysis used
was prevalent ratio (RP). Results: Over
27 patients, 12 (44.4%) were diagnosed with definite TB meningitis. Statistical
analysis showed that prevalence ratio of the increased levels of protein CSF
was 3.143 (95% CI: 0.502 to 19.692), decreased glucose levels was 1.750 (95%
CI: 0.501 to 6.112), pleocytosis with a predominance of mononuclear cells was
2.5 (CI 95% : 1.238 to 5.048), whereas the CFS abnormality was RP 2.2 (95% CI:
1.087 to 4.454). Conclusion: This study has shown that pleocytosis with
mononuclear cells predominance and CFS abnormalities have a positive
relationship with definite TB meningitis.
Author: Masfiyah, Subakir, Tri
Nur Kristina
Journal Code: jpkedokterangg160045
