THE DIAGNOSIS OF TUBERCULOUS MENINGITIS BY DETECTION OF MYCOBACTERIUM TUBERCULOSIS DNA IN CEREBROSPINAL FLUID USING PCR TECHNIQUE

Abstract

Objective: To determine the frequency of positive mycobacterial PCR technique in cerebrospinal fluid (CSF) in patients with suspected tuberculous meningitis. Materials and methods: A cross-sectional study was conducted in the Department of Medicine Khyber Teaching Peshawar KPK from June 2020 to June 2021 over patients above the age of 15 years having clinical suspicion of tuberculous meningitis with cerebrospinal fluid showing raised protein, increased lymphocytes, and low CSF sugar levels. After performing a lumbar puncture 2.5 ccs of CSF was collected in a special bottle and sent to the laboratory for detection of Mycobacterial Tuberculosis (MTB) DNA. Data were analyzed by SPSS version 26. Results were displayed in tables and graphs. Results: Out of the total 100 patients, 49 (49%) were male and 51 (51%) were female. The mean age of the patients was 47.16±16.5 years (16- 82 years). The mean CSF cell count was 626/ cm3, the CSF protein level was 188.5±87 gram/dl and the mean CSF glucose level was 46±10 mg/dl ranging from 30 to 66 mg/dl. Mycobacterial PCR was positive for mycobacterium DNA in 70% of patients and negative in 30% of patients. MTB PCR in cerebrospinal fluid showed a strong correlation with CSF protein levels (p-value <0.000) Conclusion: Due to the high prevalence of positive PCR for the detection of MTB, every patient with a lymphocytic predominant picture of CSF examination and high protein should undergo MTB PCR testing for Mycobacterium tuberculosis. KEYWORDS Mycobacterium tuberculosis, meningitis, polymerase chain reaction, cerebrospinal fluid