Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features

摘要: Summary Background The diagnosis of tuberculous meningitis is difficult. Discrimination cases from those bacterial by clinical features alone often impossible, and current laboratory methods remain inadequate or inaccessible in developing countries. We aimed to create a simple diagnostic aid for adults on the basis basic features. Methods compared admission 251 at an infectious disease hospital Vietnam who satisfied criteria (n=143) (n=108) meningitis. Features independently predictive were modelled multivariate logistic regression rule, classification-tree method. performance both aids was assessed resubstitution prospective test data methods. Findings Five meningitis: age, length history, white-blood-cell count, total cerebrospinal fluid white-cell neutrophil proportion. A rule developed these 97% sensitive 91% specific resubstitution, 86% 79% when applied prospectively further 42 with meningitis, 33 corresponding values classification tree 99% 93% 88% 70% data. Interpretation This study suggests that can help Although usefulness will vary depending prevalence tuberculosis HIV-1 infection, we suggest it be low glucose, particularly settings limited microbiological resources.