Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: A case report

Serena Vita, Camilla Ajassa, Emanuela Caraffa, Miriam Lichtner, Claudia Mascia, Fabio Mengoni, Maria Grazia Paglia, Cristina Mancarella, Davide Colistra, Claudio Di Biasi, Rosa Maria Ciardi, Claudio Maria Mastroianni, Vincenzo Vullo

Research output: Contribution to journalArticle

Abstract

Background: Pediatric tuberculous meningitis is a highly morbid, often fatal disease. Its prompt diagnosis and treatment saves lives, in fact delays in the initiation of therapy have been associated with high mortality rates. Case presentation: This is a case of an Italian child who was diagnosed with tuberculous meningitis after a history of a month of headache, fatigue and weight loss. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis with predominance and decreased glucose concentration. Microscopy and conventional diagnostic tests to identify Mycobacterium tuberculosis were negative, while a non classical method based on intracellular cytokine flow cytometry response of CD4 cells in cerebral spinal fluid helped us to address the diagnosis, that was subsequently confirmed by a nested polymerase chain reaction amplifying a 123 base pair fragment of the M. tuberculosis DNA. Conclusions: We diagnosed tuberculous meningitis at an early stage through an innovative immunological approach, supported by a nested polymerase chain reaction for detection of M. tuberculosis DNA. An early diagnosis is required in order to promptly initiate a therapy and to increase the patient's survival.

Original languageEnglish
Article number123
JournalBMC Research Notes
Volume10
Issue number1
DOIs
Publication statusPublished - Mar 13 2017

Keywords

  • Children
  • Hydrocephalus
  • ICCFC
  • Immunological diagnosis
  • Tuberculous meningitis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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    Vita, S., Ajassa, C., Caraffa, E., Lichtner, M., Mascia, C., Mengoni, F., Paglia, M. G., Mancarella, C., Colistra, D., Di Biasi, C., Ciardi, R. M., Mastroianni, C. M., & Vullo, V. (2017). Immunological diagnosis as an adjunctive tool for an early diagnosis of tuberculous meningitis of an immune competent child in a low tuberculosis endemic country: A case report. BMC Research Notes, 10(1), [123]. https://doi.org/10.1186/s13104-017-2444-9