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Diagnostic risk factors to differentiate tuberculous and acute bacterial meningitis

Moghtaderi, A., Alavi-Naini, R., Izadi, S. and Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 (2009) 'Diagnostic risk factors to differentiate tuberculous and acute bacterial meningitis'. Scandinavian Journal of Infectious Diseases, Vol 41, Issue 3, pp. 188-194.

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Abstract

The objective of this study was to identify independent predictor factors for diagnosis of tuberculous meningitis and develop a clinical prediction tool based upon a set of simple clinical and laboratory parameters in our local population. Clinical and laboratory features were compared in 68 patients with tuberculous meningitis and 123 cases of acute bacterial meningitis in 3 referral centres for tuberculosis in south-eastern Iran. Twenty-two clinical and laboratory features were analysed. Based on the best-fitted model a receiver operating characteristic curve with the highest surface under the curve was constructed. Disease duration before diagnosis (5 d) had the highest odds ratio of 21.9. Age over 30 y, CSF leukocyte count 1000103 cells/ml and CSF lymphocytosis 70% were placed after disease duration with odds ratios of 5.1, 3.7 and 2.6, respectively. Sensitivity, specificity and likelihood ratio for a positive test in this model were 84%, 88% and 7.4, respectively. The area under the ROC curve was 0.92. It appears that a single model can not predict TBM diagnosis in different populations. Using clinical and laboratory parameters may facilitate empirical diagnosis of TBM in endemically low income countries with limited microbiological diagnostic facilities.

Item Type: Article
Uncontrolled Keywords: adults Tuberculous Meningitis Acute Bacterial Meningitis Low-Income Symptoms
Subjects: WB Practice of Medicine > Diagnosis > General Diagnosis > WB 143 Signs and symptoms
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WC Communicable Diseases > Infection. Bacterial Infections > Bacterial Infections > WC 245 Meningococcal infections
WB Practice of Medicine > Diagnosis > General Diagnosis > WB 141 General works
WA Public Health > Preventive Medicine > WA 243 Diagnositic services
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WL Nervous System > WL 200 Meninges. Blood-brain barrier
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1080/00365540902721384
Depositing User: Pauline Anderson
Date Deposited: 12 Mar 2010 15:04
Last Modified: 06 Feb 2018 12:59
URI: http://archive.lstmed.ac.uk/id/eprint/329

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