Diagnostic Challenges and Prospects Associated With Zoonotic Tuberculosis of Central Nervous System

Prachi R. Bapat, Seema D. Shekhawat, Aliabbas A. Husain, Renuka S. Dodkey, Hatim F. Daginawala, Lokendra K. Singh
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Abstract

Introduction: The diagnosis of Tuberculous Meningitis (TBM) has remained a challenge due to its insidious onset and the failure of conventional diagnostic tests. The present study aimed to identify the mycobacterial pathogen in the CSF of patients with TBM and a poor prognosis. Methods: We retrospectively recruited 224 TBM and 34 non-TBM patients admitted to the Central India Institute of Medical Sciences, Nagpur, India, in 2014. The CSF samples of these patients were subjected to a duplex PCR assay for the species-specific identification of the causative pathogen. Results: M. bovis and infection with M.tuberculosis were detected in 7% (18) and 32.9% (85) of the patients, respectively. Moreover, 14% (36) of the study samples were culture positive; however, the mycobacterial pathogens could not be differentiated to the species level.  Conclusion: The present study findings emphasized the potentially vital importance of M. bovis identification for appropriate patient management. The obtained data also demonstrated the persistent significance of M. bovis, as a zoonotic pathogen.
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与中枢神经系统人畜共患结核相关的诊断挑战和前景
结核性脑膜炎(TBM)的诊断一直是一个挑战,由于其潜伏的起病和失败的传统诊断测试。本研究旨在鉴定预后不良的TBM患者脑脊液中的分枝杆菌病原体。方法:回顾性招募2014年印度那格浦尔中央印度医学科学研究所收治的224例TBM患者和34例非TBM患者。对这些患者的脑脊液样本进行双链聚合酶链反应测定,以确定病原体的物种特异性。结果:检出牛分枝杆菌18例(7%),结核分枝杆菌85例(32.9%);此外,14%(36)的研究样本培养阳性;但分枝杆菌致病菌不能分化到种水平。结论:目前的研究结果强调了牛支原体鉴定对适当患者管理的潜在至关重要的意义。所获得的数据也证明了牛分枝杆菌作为一种人畜共患病原体的持久意义。
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