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The dubious value of cerebrospinal fluid adenosine deaminase measurement for the diagnosis of tuberculous meningitis
- Source :
- BMC Infectious Diseases
- Publication Year :
- 2017
- Publisher :
- Springer Science and Business Media LLC, 2017.
-
Abstract
- Background The diagnosis of tuberculous meningitis (TBM) can be extremely difficult in the absence of culture confirmation. Cerebrospinal fluid (CSF) adenosine deaminase (ADA) can potentially assist in this regard, although its current value remains unclear. The literature on the usefulness of CSF ADA in TBM diagnosis is inconsistent, especially from an analytical point of view. Methods A retrospective analysis of clinical and laboratory data relating to all CSF ADA requests during 2009 and 2010 in a South African quaternary healthcare setting was performed. A CSF ADA cut-off for TBM diagnosis was calculated using receiver operating characteristic curve analysis. The performance of CSF ADA in different infective and non-infective categories was assessed. Results In total, 3548 CSF ADA requests were considered over the 2-year period. Of these, 1490 were for patients for whom both a CSF ADA and a mycobacterial culture were requested. The optimal cut-off was calculated at 2.0 U/L (AUC = 0.86; 95% CI = 0.82 – 0.89; p-value
- Subjects :
- Adult
Male
0301 basic medicine
medicine.medical_specialty
Tuberculosis
Adenosine Deaminase
030106 microbiology
Pre-analytical
Sensitivity and Specificity
Tuberculous meningitis
03 medical and health sciences
0302 clinical medicine
Cerebrospinal fluid
Adenosine deaminase
Internal medicine
medicine
Humans
Meningitis
030212 general & internal medicine
Retrospective Studies
Giusti
Receiver operating characteristic
biology
business.industry
Mycobacterial culture
medicine.disease
Surgery
Infectious Diseases
ROC Curve
Tuberculosis, Meningeal
biology.protein
Adenosine deaminase measurement
Female
business
Youden
Research Article
Subjects
Details
- ISSN :
- 14712334
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....64593b3af429f021f3a65aa7c3b22151