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Improving Technology to Diagnose Tuberculous Meningitis: Are We There Yet?
- Source :
- Frontiers in Neurology; 5/30/2022, Vol. 13, p1-8, 8p
- Publication Year :
- 2022
-
Abstract
- Diagnosis of tuberculous meningitis (TBM) remains challenging due to a paucity of high-performance diagnostics. Even those that have reasonable sensitivity are not adequate to 'rule out' TBM. Therefore, a combination of clinical factors alongside microbiological, molecular, and radiological investigations are utilized, depending on availability. A low threshold for starting empiric therapy in the appropriate clinical scenario remains crucial for good outcomes in many cases. Herein, we review the current TBM diagnostics landscape with a focus on limitations frequently encountered, such as diagnostic test performance, cost, laboratory infrastructure, and clinical expertise. Though molecular technologies, particularly GeneXpert MTB/Rif Ultra, have been a step forward, diagnosis of TBM remains difficult. We also provide an overview of promising technologies, such as cerebrospinal fluid (CSF) lactate, a new lipoarabinomannan test (FujiLAM), metagenomic next-generation sequencing, and transcriptomics that may further improve our TBM diagnostic capacity and lead to better outcomes. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 16642295
- Volume :
- 13
- Database :
- Complementary Index
- Journal :
- Frontiers in Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 157190038
- Full Text :
- https://doi.org/10.3389/fneur.2022.892224