TB-PCR, UTILITY IN PRESENT SCENARIO - STUDY FROM TERTIARY CARE CENTER IN NORTHERN INDIA.

Abstract

TBM is a syndrome of sub-acute lymphocytic meningitis in the majority of patients. When diagnosed promptly, TBM can be cured with supervised medication administration and supportive care. Even after many years of experience with the disease, the definitive diagnosis of TBM remains a problem. The nucleic acid amplification technique (NAA), notably the polymerase chain reaction (PCR) has revolutionized the investigative microbiology by facilitating direct detection and identification of infectious agent in the clinical samples in a very short time. AIM: Role of TB-PCR, in the diagnosis of tuberculous meningitis MATERIALS AND METHODS: This prospective study was done in Department of Medicine, and Department of Neurology over the one-year duration. The subjects were comprised of the patients above 10 years of age who got admitted with clinical picture commensurate with Meningitis were assessed on Thwarts Criteria and those found to be likely cases of T.B.M, as per the criteria were included in the study, and TB-PCR was done. RESULTS: Taking PCR positivity as the diagnostic test and evaluating its efficacy against Thwaites score <4, out of 99 cases of TBM, 42 were found to be true positive and 57 were false negative. CONCLUSION: Taking PCR positivity as the diagnostic test, out of 99 cases of TBM diagnosed by Thwaites score only 42.42% (n=42) were found to be true positive, hence it is not a good test for the diagnosis of Tuberculous meningitis