Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review
Background Cerebrospinal fluid (CSF) examinations play an important role in the diagnosis of tuberculous meningitis (TBM). However, their yield in the diagnosis of infant TBM remains unclear. This scoping review aims to detail the role of CSF examination for the diagnosis of infant TBM.Methods A com...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2022.2123560 |
| _version_ | 1828104860563668992 |
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| author | Jie Hou Xin-Jie Liu Yu He Yan-An Zhang Mao-Shui Wang |
| author_facet | Jie Hou Xin-Jie Liu Yu He Yan-An Zhang Mao-Shui Wang |
| author_sort | Jie Hou |
| collection | DOAJ |
| description | Background Cerebrospinal fluid (CSF) examinations play an important role in the diagnosis of tuberculous meningitis (TBM). However, their yield in the diagnosis of infant TBM remains unclear. This scoping review aims to detail the role of CSF examination for the diagnosis of infant TBM.Methods A comprehensive literature search of PubMed, EBSCO, Embase, Scopus, Web of Science, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials was performed to identify articles published prior to October 14th, 2021. Articles describing the results of CSF exanimations among infant TBM were eligible for inclusion. Data extracted from each study included age, sex, CSF microbiological evidence (such as AFB smear, TB PCR, and TB culture), and routine CSF examinations (such as appearance, red blood cell count, white blood cell count, protein, and glucose).Results A total of 98 cases were included in the final analysis. The yield of microbiological methods was listed as follows: CSF AFB smear, 20.5% (9/44); CSF TB culture 47.5% (29/61); CSF TB PCR, 65.0% (26/40); the combination of them, 57.3% (47/82). According to Marais criteria, the positivities of CSF examinations were calculated as follows: WBC count (ref, 50–500/μL), 65.5% (55/84); lymphocyte predominance (ref, >0.5), 75.4% (49/65); total protein (ref, >100 mg/dL), 67.8% (59/87); glucose (ref, <2.2 mmol/L, or CSF/serum ratio < 0.5), 68.2% (58/85).Conclusions Our data demonstrated that routine microbiological tools for infant TBM diagnosis have a sensitivity ranging from 20.5% to 65.0%, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis.Key messages: Routine microbiological tools (such as acid-fast bacilli smear, PCR, and culture) have an unsatisfactory sensitivity for infant TBM diagnosis, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis. |
| first_indexed | 2024-04-11T09:54:35Z |
| format | Article |
| id | doaj.art-f1dc570ebdce4fca80cb0e1305158ff7 |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-04-11T09:54:35Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-f1dc570ebdce4fca80cb0e1305158ff72022-12-22T04:30:42ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602022-12-015412517252110.1080/07853890.2022.2123560Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping reviewJie Hou0Xin-Jie Liu1Yu He2Yan-An Zhang3Mao-Shui Wang4Department of Intensive Care, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, ChinaDepartment of Cardiovascular Surgery, Shandong Public Health Clinical Center, Cheeloo College of Medicine, Shandong University, Jinan, ChinaShandong Key Laboratory of Infectious Respiratory Disease, Jinan, ChinaBackground Cerebrospinal fluid (CSF) examinations play an important role in the diagnosis of tuberculous meningitis (TBM). However, their yield in the diagnosis of infant TBM remains unclear. This scoping review aims to detail the role of CSF examination for the diagnosis of infant TBM.Methods A comprehensive literature search of PubMed, EBSCO, Embase, Scopus, Web of Science, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials was performed to identify articles published prior to October 14th, 2021. Articles describing the results of CSF exanimations among infant TBM were eligible for inclusion. Data extracted from each study included age, sex, CSF microbiological evidence (such as AFB smear, TB PCR, and TB culture), and routine CSF examinations (such as appearance, red blood cell count, white blood cell count, protein, and glucose).Results A total of 98 cases were included in the final analysis. The yield of microbiological methods was listed as follows: CSF AFB smear, 20.5% (9/44); CSF TB culture 47.5% (29/61); CSF TB PCR, 65.0% (26/40); the combination of them, 57.3% (47/82). According to Marais criteria, the positivities of CSF examinations were calculated as follows: WBC count (ref, 50–500/μL), 65.5% (55/84); lymphocyte predominance (ref, >0.5), 75.4% (49/65); total protein (ref, >100 mg/dL), 67.8% (59/87); glucose (ref, <2.2 mmol/L, or CSF/serum ratio < 0.5), 68.2% (58/85).Conclusions Our data demonstrated that routine microbiological tools for infant TBM diagnosis have a sensitivity ranging from 20.5% to 65.0%, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis.Key messages: Routine microbiological tools (such as acid-fast bacilli smear, PCR, and culture) have an unsatisfactory sensitivity for infant TBM diagnosis, and most CSF features are non-specific and insufficient to predict a diagnosis of infant TBM. Therefore, further effort is required to develop new tools for infant TBM diagnosis.https://www.tandfonline.com/doi/10.1080/07853890.2022.2123560Infanttuberculous meningitisdiagnosisscoping review |
| spellingShingle | Jie Hou Xin-Jie Liu Yu He Yan-An Zhang Mao-Shui Wang Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review Annals of Medicine Infant tuberculous meningitis diagnosis scoping review |
| title | Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review |
| title_full | Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review |
| title_fullStr | Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review |
| title_full_unstemmed | Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review |
| title_short | Cerebrospinal fluid findings of infant tuberculous meningitis: a scoping review |
| title_sort | cerebrospinal fluid findings of infant tuberculous meningitis a scoping review |
| topic | Infant tuberculous meningitis diagnosis scoping review |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2022.2123560 |
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