ArticleThe Journal of infectious diseases2019
Pretreatment Cerebrospinal Fluid Bacterial Load Correlates With Inflammatory Response and Predicts Neurological Events During Tuberculous Meningitis Treatment.
Article in The Journal of infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- Ischaemia in tuberculous meningitis: update on pathophysiology, clinical predictors and management.Current opinion in infectious diseases · 2026Review
- Cerebrospinal Fluid Hypo-inflammation Drives Mortality in HIV-Associated Tuberculous Meningitis.The Journal of infectious diseases · 2026Article
- Contribution of cytotoxic CD8 T cells, neutrophils and type 1 interferon signaling to hyperinflammation in HIV-associated TB meningitis.bioRxiv : the preprint server for biology · 2026Article
- Anti-TB treatment outcomes in TB meningitis: A systematic review and meta-analysis.New microbes and new infections · 2025Review
- Pre-treatment untargeted cerebrospinal fluid metabolomic profiling in tuberculous meningitis uncovers pathways associated with mortality.Med (New York, N.Y.) · 2025Article
- Article
- The Ability of a 3-Gene Host Signature in Blood to Distinguish Tuberculous Meningitis From Other Brain Infections.The Journal of infectious diseases · 2024Article
- Disease spectrum and prognostic factors in patients treated for tuberculous meningitis in Shaanxi province, China.Frontiers in microbiology · 2024Article
- Review
- Tryptophan metabolism determines outcome in tuberculous meningitis: a targeted metabolomic analysis.eLife · 2023Article
- Tryptophan metabolism determines outcome in tuberculous meningitis: a targeted metabolomic analysis.medRxiv : the preprint server for health sciences · 2023Article
- Recent advances in understanding the human host immune response in tuberculous meningitis.Frontiers in immunology · 2023Review
- Review
- Influence of Strongyloides stercoralis Coinfection on the Presentation, Pathogenesis, and Outcome of Tuberculous Meningitis.The Journal of infectious diseases · 2022Article
- Myelitis: A Common Complication of Tuberculous Meningitis Predicting Poor Outcome.Frontiers in neurology · 2022Article
- Cerebrospinal Fluid Bacillary Load by Xpert MTB/RIF Ultra Polymerase Chain Reaction Cycle Threshold Value Predicts 2-Week Mortality in Human Immunodeficiency Virus-Associated Tuberculous Meningitis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Central nervous system tuberculosis.Current opinion in neurology · 2021Review
- Evaluation of the molecular bacterial load assay for detecting viable Mycobacterium tuberculosis in cerebrospinal fluid before and during tuberculous meningitis treatment.Tuberculosis (Edinburgh, Scotland) · 2021Article
- Xpert MTB/RIF Ultra versus Xpert MTB/RIF for the diagnosis of tuberculous meningitis: a prospective, randomised, diagnostic accuracy study.The Lancet. Infectious diseases · 2020Article
- The Lyme disease bacterium, Borrelia burgdorferi, stimulates an inflammatory response in human choroid plexus epithelial cells.PloS one · 2020Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe Mycobacterium tuberculosis load in the brain of individuals with tuberculous meningitis (TBM) may reflect the host's ability to control the pathogen, determine disease severity, and determine treatment outcomes.
methodsWe used the GeneXpert assay to measure the pretreatment M. tuberculosis load in cerebrospinal fluid (CSF) specimens from 692 adults with TBM. We sought to understand the relationship between CSF bacterial load and inflammation, and their respective impact on disease severity and treatment outcomes.
resultsA 10-fold higher M. tuberculosis load was associated with increased disease severity (odds ratio, 1.59; P = .001 for the comparison between grade 1 and grade 3 severity), CSF neutrophil count (r = 0.364 and P < .0001), and cytokine concentrations (r = 0.438 and P < .0001). A high M. tuberculosis load predicted new neurological events after starting treatment (P = .005, by multinomial logistic regression) but not death. Patients who died had an attenuated inflammatory response at the start of treatment, with reduced cytokine concentrations as compared to survivors. In contrast, patients with high pretreatment CSF bacterial loads, cytokine concentrations, and neutrophil counts were more likely to subsequently experience neurological events.
conclusionsThe pretreatment GeneXpert-determined M. tuberculosis load may be a useful predictor of neurological complications occurring during TBM treatment. Given the evidence for the divergent pathogenesis of TBM-associated neurological complications and deaths, therapeutic strategies to reduce them may need reassessment.
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