Abstract:

Objective To evaluate the clinical value of three methods in early diagnosis of tuberculous meningitis (TBM). Methods The cerebrospinal fluid specimens (CSF) of 45 patients with TBM and the samples of 42 patients with non-TBM were collected from patients admitted to Hebei Chest Hospital and the Fifth Hospital of Shijiazhuang between August 2016 and June 2018. Three methods, including conventional acid fast stain, modified acid fast stain, and GeneXpert MTB/RIF assay were used to detect the mycobacterium in the CSF specimens for diagnosis of TBM. SPSS 19.0 software was used for statistical analysis. The comparison of the rates was made by χ ² test and corrected χ ² test, P<0.05 was statistically significant. Results Based on clinical diagnosis, the sensitivity was 4.44% (2/45), 88.89% (40/45), 35.56% (16/45) in the TBM group as tested by conventional acid fast stain, modified acid fast stain, and GeneXpert MTB/RIF assay respectively. There was significant difference between the three methods in the sensitivity (χ ²=64.46, 13.16, 27.23, P=0.000). No mycobacterium was detected in the samples of non-TBM group. The specificity of three detection techniques for mycobacterium was 100.00%. Conclusion The sensitivity of the modified acid fast staining method is higher than that of the conventional acid fast stain and GeneXpert MTB/RIF assay in detection of the mycobacterium in CSF. It is worthwhile for the early diagnosis of TBM.

Key words: Tuberculosis,meningeal, Cerebrospinal fluid, Early diagnosis, Laboratory techniques and procedures, Comparative study, Data interpretation,statististics