Evidence map›Paper›PMID 39135250›Full record

ArticleInternal medicine (Tokyo, Japan)2025

Persistence Pays: Diagnosing Tuberculous Meningitis after 11 Negative Polymerase Chain Reaction Evaluations.

Kazuki Obara, Takashi Tsuboi, Yu Mori, Akihiro Sanda, Naohiro Mouri, Shinnosuke Takagi, Shinichiro Aoki, Masahisa Katsuno

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Internal medicine (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kazuki ObaraDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Takashi TsuboiDepartment of Neurology, Nagoya University Graduate School of Medicine, Japan.
Yu MoriDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Akihiro SandaDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Naohiro MouriDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Shinnosuke TakagiDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Shinichiro AokiDepartment of Neurology, Gifu Prefectural Tajimi Hospital, Japan.
Masahisa KatsunoDepartment of Neurology, Nagoya University Graduate School of Medicine, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Managing tuberculous meningitis (TBM) is challenging because of its poor prognosis and the difficulty in making an early diagnosis due to the low sensitivity of cerebrospinal fluid (CSF) polymerase chain reaction (PCR) evaluations. A 75-year-old woman presented with fatigue and multiple enlarged lymph nodes and was initially suspected of having metastatic cancer of unknown primary origin. Differential diagnoses included carcinomatous meningitis, neurosarcoidosis, and TBM, as suggested by the presence of multiple enhancing cerebral nodules. Despite 11 negative PCR evaluations, including nested PCR of CSF and biopsied lymph nodes within the first 3 days of empirical anti-tubercular treatment, TBM was eventually confirmed by CSF cultures 32 days later. This case highlights the need for repeated sampling.

Indexed as

Polymerase Chain ReactionTuberculosis, MeningealAgedAntitubercular AgentsDiagnosis, DifferentialFemaleHumansMycobacterium tuberculosisAntitubercular Agentscentral nervous system tuberculosisdisseminated tuberculosisnested polymerase chain reactionsensitivitytuberculous meningitis

Identifiers

PMID39135250
PMCPMC11986298

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Registered trials

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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.