Cerebrospinal fluid analysis in tuberculous meningitis: A literature review
Abstract
BACKGROUND: Tuberculous meningitis (TBM) is the most common central nervous system infection of Mycobacterium tuberculosis (M.tb). The infection will cause focal neurological deficits and can be fatal, so that it will increase the morbidity and mortality rates. Adequate treatment is needed so that the drug can reach the center of infection. Not all anti-tuberculosis (TB) drugs can effectively cross the blood-brain and blood-cerebrospinal fluid barriers. The use of higher doses is expected to be able to work on the center of infection effectively. However, the use of higher doses will also increase the risk of drug-induced liver injury, which requires temporary discontinuation of the suspected drug.
METHODS: This scientific work aims to determine the penetration rate of first-line anti-TB drugs that are often used in patients infected with M.tb, especially TBM. Journal searches were performed on PubMed/PMC and BioMed Central/BMC search engines with the appropriate keywords. Critical appraisal analysis was carried out in selected journals. CSF sampling can be done to establish the diagnosis of TBM. CSF characteristics in TBM include lymphocyte pleocytosis, increased protein levels, and decreased glucose levels.
RESULTS: The results of CSF analysis depend on the volume of CSF used, the delivery of the sample, and the technical expertise of the clinician. If clinically, a patient is suspected of having TBM even though the results of CSF analysis show negative results for M.tb…
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