Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study
Objective: The aim of our study was to retrospectively validate a previously described rapid clinical score (RCS) in distinguishing tuberculous meningitis (TBM) from viral meningitis (VM) in people who are at increased risk of tuberculosis, as well as from cryptococcal meningitis (CM) in HIV-infecte...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=4;spage=363;epage=366;aulast=Jipa |
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| author | Raluca Jipa Ioana D Olaru Eliza Manea Simona Merisor Adriana Hristea |
| author_facet | Raluca Jipa Ioana D Olaru Eliza Manea Simona Merisor Adriana Hristea |
| author_sort | Raluca Jipa |
| collection | DOAJ |
| description | Objective: The aim of our study was to retrospectively validate a previously described rapid clinical score (RCS) in distinguishing tuberculous meningitis (TBM) from viral meningitis (VM) in people who are at increased risk of tuberculosis, as well as from cryptococcal meningitis (CM) in HIV-infected patients. Methods: We performed a retrospective study of patients admitted with a diagnosis of aseptic meningitis between January 2012 and December 2015, to a referral hospital for infectious diseases. The variables included in RCS were duration of symptoms before admission, neurological stage, cerebrospinal fluid (CSF) to blood glucose ratio, and CSF protein. We included in this retrospective study 31 patients with definite or probable TBM including 14 HIV-infected patients, 62 HIV-noninfected patients with VM, and 18 HIV-infected patients with CM. Results: The sensitivity of RCS to distinguish TBM from VM was 96.7%, with a specificity of 81.1% and the area under the receiver operating characteristic (ROC) curve was 0.949 (0.90–0.99). When all four criteria from the RCS were present, the specificity increased at 100%. In HIV-infected patients, the sensitivity and specificity of RCS in differentiating TBM from CM were 86.6% and 27.7%, respectively, and the area under the ROC curve was 0.669 (0.48–0.85). Conclusion: This easy-to-use RCS was found to be helpful in differentiating TBM from VM, with a better sensitivity than molecular amplification techniques and a relatively good specificity. However, the RCS was not useful to differentiate between TBM and CM in HIV-infected patients. |
| first_indexed | 2024-12-11T11:27:56Z |
| format | Article |
| id | doaj.art-dc23dd4fcc5c4963860c5898e3c33ecc |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-11T11:27:56Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-dc23dd4fcc5c4963860c5898e3c33ecc2022-12-22T01:08:58ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492017-01-0120436336610.4103/aian.AIAN_219_17Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort studyRaluca JipaIoana D OlaruEliza ManeaSimona MerisorAdriana HristeaObjective: The aim of our study was to retrospectively validate a previously described rapid clinical score (RCS) in distinguishing tuberculous meningitis (TBM) from viral meningitis (VM) in people who are at increased risk of tuberculosis, as well as from cryptococcal meningitis (CM) in HIV-infected patients. Methods: We performed a retrospective study of patients admitted with a diagnosis of aseptic meningitis between January 2012 and December 2015, to a referral hospital for infectious diseases. The variables included in RCS were duration of symptoms before admission, neurological stage, cerebrospinal fluid (CSF) to blood glucose ratio, and CSF protein. We included in this retrospective study 31 patients with definite or probable TBM including 14 HIV-infected patients, 62 HIV-noninfected patients with VM, and 18 HIV-infected patients with CM. Results: The sensitivity of RCS to distinguish TBM from VM was 96.7%, with a specificity of 81.1% and the area under the receiver operating characteristic (ROC) curve was 0.949 (0.90–0.99). When all four criteria from the RCS were present, the specificity increased at 100%. In HIV-infected patients, the sensitivity and specificity of RCS in differentiating TBM from CM were 86.6% and 27.7%, respectively, and the area under the ROC curve was 0.669 (0.48–0.85). Conclusion: This easy-to-use RCS was found to be helpful in differentiating TBM from VM, with a better sensitivity than molecular amplification techniques and a relatively good specificity. However, the RCS was not useful to differentiate between TBM and CM in HIV-infected patients.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=4;spage=363;epage=366;aulast=JipaClinical scorediagnosistuberculous meningitis |
| spellingShingle | Raluca Jipa Ioana D Olaru Eliza Manea Simona Merisor Adriana Hristea Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study Annals of Indian Academy of Neurology Clinical score diagnosis tuberculous meningitis |
| title | Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study |
| title_full | Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study |
| title_fullStr | Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study |
| title_full_unstemmed | Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study |
| title_short | Rapid clinical score for the diagnosis of tuberculous meningitis: A retrospective cohort study |
| title_sort | rapid clinical score for the diagnosis of tuberculous meningitis a retrospective cohort study |
| topic | Clinical score diagnosis tuberculous meningitis |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2017;volume=20;issue=4;spage=363;epage=366;aulast=Jipa |
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