Trial reportAmerican journal of respiratory and critical care medicine2014
Diagnostic accuracy of intracellular mycobacterium tuberculosis detection for tuberculous meningitis.
Trial report in American journal of respiratory and critical care medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- A systematic review and meta-analysis of the diagnostic accuracy of metagenomic next-generation sequencing for diagnosing tuberculous meningitis.Frontiers in immunology · 2023Pooled it
- Cerebrospinal fluid AFB smear in adults with tuberculous meningitis: A systematic review and diagnostic test accuracy meta-analysis.Tuberculosis (Edinburgh, Scotland) · 2022Pooled it
- Machine learning models based on laboratory data: new insight into the differential diagnosis of tuberculous and viral meningitis.Frontiers in cellular and infection microbiology · 2026Article
- Meningitis diagnosis, treatment, and outcomes in rural, northern Uganda: 2015-2024.PLOS global public health · 2026Article
- Miliary Tuberculosis: A Comprehensive Review of Epidemiology, Clinical Manifestations, Diagnosis, Treatment, and Complications.Infection and drug resistance · 2026Review
- Systemic Inflammation Predict Neurological Functional Outcome in Patients with Tuberculous Meningitis: A Multicenter Retrospective Cohort Study in China.Journal of inflammation research · 2024Article
- Disease spectrum and prognostic factors in patients treated for tuberculous meningitis in Shaanxi province, China.Frontiers in microbiology · 2024Article
- Case report: Autoimmune glial fibrillary acidic protein astrocytopathy misdiagnosed as tuberculous meningitis.Frontiers in neurology · 2023Article
- Recent advances in microbiological and molecular biological detection techniques of tuberculous meningitis.Frontiers in microbiology · 2023Review
- Aptamer Detection ofFrontiers in cellular and infection microbiology · 2021Article
- Epidemiology of Noble Pen Shell (Pathogens (Basel, Switzerland) · 2020Article
- Longitudinal cerebrospinal fluid assessment in a patient with tuberculous meningitis-A case report.Journal of clinical laboratory analysis · 2020Article
- Improving the microbiological diagnosis of tuberculous meningitis: A prospective, international, multicentre comparison of conventional and modified Ziehl-Neelsen stain, GeneXpert, and culture of cerebrospinal fluid.The Journal of infection · 2018Article
- Tuberculosis Meningitis.Current infectious disease reports · 2017Review
- Staining with two observational methods for the diagnosis of tuberculous meningitis.Experimental and therapeutic medicine · 2016Article
- High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China.Scientific reports · 2016Article
- Neuro-Sweet disease with positive modified acid-fast staining of the cerebrospinal fluid: A case report.Experimental and therapeutic medicine · 2016Article
- Simultaneous Detection of Five Pathogens from Cerebrospinal Fluid Specimens Using Luminex Technology.International journal of environmental research and public health · 2016Article
- Sub-optimal Specificity of Modified Ziehl-Neelsen Staining for Quick Identification of Tuberculous Meningitis.Frontiers in microbiology · 2016Article
- Definite (microbiologically confirmed) tuberculous meningitis: predictors and prognostic impact.Infection · 2015Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
38 authors at 14 institutions in 3 countries.
Funding
Abstract
rationaleEarly diagnosis and treatment of tuberculous meningitis saves lives, but current laboratory diagnostic tests lack sensitivity.
objectivesWe investigated whether the detection of intracellular bacteria by a modified Ziehl-Neelsen stain and early secretory antigen target (ESAT)-6 in cerebrospinal fluid leukocytes improves tuberculous meningitis diagnosis.
methodsCerebrospinal fluid specimens from patients with suspected tuberculous meningitis were stained by conventional Ziehl-Neelsen stain, a modified Ziehl-Neelsen stain involving cytospin slides with Triton processing, and an ESAT-6 immunocytochemical stain. Acid-fast bacteria and ESAT-6-expressing leukocytes were detected by microscopy. All tests were performed prospectively in a central laboratory by experienced technicians masked to the patients' final diagnosis. MEASUREMENTS AND MAIN
resultsTwo hundred and eighty patients with suspected tuberculous meningitis were enrolled. Thirty-seven had Mycobacterium tuberculosis cultured from cerebrospinal fluid; 40 had a microbiologically confirmed alternative diagnosis; the rest had probable or possible tuberculous meningitis according to published criteria. Against a clinical diagnostic gold standard the sensitivity of conventional Ziehl-Neelsen stain was 3.3% (95% confidence interval, 1.6-6.7%), compared with 82.9% (95% confidence interval, 77.4-87.3%) for modified Ziehl-Neelsen stain and 75.1% (95% confidence interval, 68.8-80.6%) for ESAT-6 immunostain. Intracellular bacteria were seen in 87.8% of the slides positive by the modified Ziehl-Neelsen stain. The specificity of modified Ziehl-Neelsen and ESAT-6 stain was 85.0% (95% confidence interval, 69.4-93.8%) and 90.0% (95% confidence interval, 75.4-96.7%), respectively.
conclusionsEnhanced bacterial detection by simple modification of the Ziehl-Neelsen stain and an ESAT-6 intracellular stain improve the laboratory diagnosis of tuberculous meningitis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.