ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2015
The diagnostic value of cerebrospinal fluid chemistry results in childhood tuberculous meningitis.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 33 citations in OpenAlex.
- Insights from LC-MS-based cerebrospinal fluid metabolomics in tuberculous meningitis.Frontiers in molecular biosciences · 2026Article
- Central Nervous System Infections Caused by Bacillus Calmette-Guerin: Case Report and Narrative Literature Review.Microorganisms · 2025Article
- Pediatric tuberculosis in Mexico: A retrospective analysis of 100 patients.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Disease spectrum and prognostic factors in patients treated for tuberculous meningitis in Shaanxi province, China.Frontiers in microbiology · 2024Article
- Autoimmune glial fibrillary acidic protein astrocytosis mimicking tuberculous meningitis: a retrospective study.Journal of neurology · 2023Article
- Tuberculous Meningitis in Children: Reducing the Burden of Death and Disability.Pathogens (Basel, Switzerland) · 2021Review
- Normal cerebrospinal fluid protein and associated clinical characteristics in children with tuberculous meningitis.Annals of medicine · 2021Article
- CSF Metabolomics of Tuberculous Meningitis: A Review.Metabolites · 2021Review
- Cerebrospinal fluid Gene XPERT (CBNAAT) in children with tuberculous meningitis.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
- Analysis of Tuberculosis Meningitis Pathogenesis, Diagnosis, and Treatment.Journal of clinical medicine · 2020Review
- Tuberculous meningitis in children: Clinical management & outcome.The Indian journal of medical research · 2019Review
- An Infant with XpertJournal of clinical medicine · 2018Article
- Comparative Diagnostic Utility of IS6110 PCR Assay in CSF and Peripheral Blood Samples of Tuberculous Meningitis Patients: A Pilot Study from Central India.Journal of clinical and diagnostic research : JCDR · 2017Article
- Cerebrospinal Fluid Amino Acid Profiling of Pediatric Cases with Tuberculous Meningitis.Frontiers in neuroscience · 2017Article
- Clinical presentations, diagnosis, mortality and prognostic markers of tuberculous meningitis in Vietnamese children: a prospective descriptive study.BMC infectious diseases · 2016Article
- High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China.Scientific reports · 2016Article
- Cerebral hemorrhage due to tuberculosis meningitis: a rare case report and literature review.Oncotarget · 2015Review
- Clinical Profile, Yield of Cartridge-based Nucleic Acid Amplification Test (GeneXpert), and Outcome in Children with Tubercular Meningitis.Journal of pediatric neurosciencesArticle
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Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCerebrospinal fluid (CSF) hypoglycorrhachia and elevated protein is well-described in bacterial meningitis, but evidence for its differential diagnostic value in tuberculous meningitis (TBM) is lacking. We aimed to assess the diagnostic utility of CSF glucose, CSF to serum glucose ratio and CSF protein in children with suspected TBM.
methodsWe describe CSF glucose and protein values as well as CSF to serum glucose ratios in a prospective evaluation of TBM suspects seen at Tygerberg Children's Hospital, Cape Town, South Africa, from January 1985 to January 2014.
resultsOf 615 TBM suspects, 88 (14%) had microbiologically confirmed TBM, 381 (62%) 'probable' TBM and 146 (24%) 'non-TBM'. Mean absolute CSF glucose concentration was significantly lower in the microbiologically confirmed (1.87 ± 1.15 mmol/L) and 'probable' TBM (1.82 ± 1.19 mmol/L) groups compared to non-TBM (3.66 ± 0.88 mmol/L). A CSF glucose concentration of <2.2 mmol/L diagnosed TBM with sensitivity 0.68 and specificity 0.96. Sensitivity using a CSF to serum glucose ratio of <0.5 was 0.90. Mean CSF protein was significantly elevated in the microbiologically confirmed TBM (1.91 ± 1.44 g/L) and 'probable' TBM (2.01 ± 1.49 g/L) groups compared to the non-TBM (0.31 ± 0.31 g/L). A CSF protein >1 g/L diagnosed TBM with sensitivity 0.78 and specificity 0.94.
conclusionAbsolute CSF glucose values of <2.2 mmol/L and protein values of >1 g/L differentiated between TBM and non-bacterial meningitis with good specificity, although sensitivity was poor. A CSF to serum glucose ratio is more informative than the absolute value.
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