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Validation of the Uniform Case Definition Criteria for Differentiating Tuberculous Meningitis, Viral Meningitis, and Bacterial Meningitis in Adults

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초록

We validated the uniform case definition for differentiating tuberculous meningitis (TBM) from both viral meningitis (VM) and bacterial meningitis (BM) in adults from South Korea, a country with an intermediate TB-burden. ‘Probable’ TBM differentiated ‘definite’ TBM with a sensitivity of 81% and specificity of 98%. ‘Possible TBM’ criteria identified ‘definite’ TBM with a sensitivity of 100% and specificity of 60%. Despite the usefulness of the uniform case definition criteria, there was substantial overlaps among VM, BM, and ‘possible’ TBM, especially in severe cases of VM and indolent cases of BM.

Abstract

We validated the uniform case definition for differentiating tuberculous meningitis (TBM) from both viral meningitis (VM) and bacterial meningitis (BM) in adults from South Korea, a country with an intermediate TB-burden. ‘Probable’ TBM differentiated ‘definite’ TBM with a sensitivity of 81% and specificity of 98%. ‘Possible TBM’ criteria identified ‘definite’ TBM with a sensitivity of 100% and specificity of 60%. Despite the usefulness of the uniform case definition criteria, there was substantial overlaps among VM, BM, and ‘possible’ TBM, especially in severe cases of VM and indolent cases of BM.

참고문헌 (7)

  1. Marais S, "Tuberculous meningitis : a uniform case definition for use in clinical research", Lancet Infect Dis, 10, pp.803~812 (2010)
  2. Solomons RS, "Uniform research case definition criteria differentiate tuberculous and bacterial meningitis in children", Clin Infect Dis, 59, pp.1574~1578 (2014)
  3. Solomons RS, "Diagnostic accuracy of a uniform research case definition for TBM in children : a prospective study", Int J Tuberc Lung Dis, 20, pp.903~908 (2016)
  4. Kim SH, "Rapid diagnosis of tuberculous meningitis by T cell-based assays on peripheral blood and cerebrospinal fluid mononuclear cells", Clin Infect Dis, 50, pp.1349~1358 (2010)
  5. Park KH, "T-cell-based assays on cerebrospinal fluid and PBMCs for rapid diagnosis of TB meningitis in non-HIV patients", Eur Respir J, 39, pp.768~770 (2012)
  6. Marais BJ, "Standardized methods for enhanced quality and comparability of tuberculous meningitis studies", Clin Infect Dis, 64, pp.501~509 (2017)
  7. Wilkinson RJ, "Tuberculous meningitis", Nat Rev Neurol, 13, pp.581~598 (2017)

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