Answer to diagnostic limitations in tuberculous meningitis

Guillem, Lluïsa; Santín, Miguel

doi:10.1016/j.eimce.2024.06.003

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"S0213005X24002258" "doi" => "10.1016/j.eimc.2024.03.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213005X24002258?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24001461?idApp=UINPBA00004N" "url" => "/2529993X/0000004200000007/v1_202408020442/S2529993X24001461/v1_202408020442/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Answer to diagnostic limitations in tuberculous meningitis" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "396" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Lluïsa Guillem, Miguel Santín" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Lluïsa" "apellidos" => "Guillem" "email" => array:1 [ 0 => "lui.gui.ti@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Miguel" "apellidos" => "Santín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Enfermedades Infecciosas, Hospital Universitari de Bellvitge-Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Tuberculosis, Departamento de Enfermedades Infecciosas, Hospital Universitari de Bellvitge-Institut d’Investigació Biomèdica de Bellvitge (IDIBELL); Departamento de Ciencias Clínicas, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a la carta sobre las limitaciones del diagnóstico de meningitis tuberculosa" ] ] "textoCompleto" => "Given the limitations of the microbiological tests, tuberculous meningitis is a diagnostic challenge. The sensitivity of the culture is very low (20%), and although molecular techniques have been perfected in recent years, their sensitivity in cerebrospinal fluid is 60%–70%.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Due to these limitations, in our study<a class="elsevierStyleCrossRef" href="#bib0010">2</a> we used the criteria defined in a consensus, created precisely with the objective of facilitating definition and comparison in clinical research.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Focusing only on microbiologically confirmed cases would have incorporated a very significant bias, excluding many of the cases and making the cohort incomparable with clinical practice, in addition to preventing comparison between periods, since molecular techniques were incorporated and developed over the course of the study period. In any event, we made the comparison between microbiologically confirmed cases and those which were not, and we found no significant differences in either mortality rates (13/60 [21.7%] vs 10/75 [13.3%], P = .20) or sequelae (14/39 [35.9%] vs 12/53 [22.6%], P = .163)." "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: progress and remaining questions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Huynh" 1 => "J. Donovan" 2 => "N.H. Phu" 3 => "H.D.T. Nghia" 4 => "N.T.T. Thuong" 5 => "G.E. Thwaites" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(21)00435-X" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol." "fecha" => "2022" "volumen" => "21" "paginaInicial" => "450" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35429482" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality and sequelae of tuberculous meningitis in a high-resource setting: a cohort study, 1990-2017" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Guillem" 1 => "J. Espinosa" 2 => "J. Laporte-Amargos" 3 => "A. Sánchez" 4 => "M.D. Grijota" 5 => "M. Santin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimce.2023.01.005" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin (Engl Ed)." "fecha" => "2024" "volumen" => "42" "paginaInicial" => "124" "paginaFinal" => "129" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36737367" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tuberculous meningitis: a uniform case definition for use in clinical research" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Marais" 1 => "G. Thwaites" 2 => "J.F. Schoeman" 3 => "M.E. Török" 4 => "U.K. Misra" 5 => "K. Prasad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1473-3099(10)70138-9" "Revista" => array:6 [ "tituloSerie" => "Lancet Infect Dis." "fecha" => "2010" "volumen" => "10" "paginaInicial" => "803" "paginaFinal" => "812" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20822958" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/2529993X/0000004200000007/v1_202408020442/S2529993X24001564/v1_202408020442/en/main.assets" "Apartado" => array:4 [ "identificador" => "66012" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/2529993X/0000004200000007/v1_202408020442/S2529993X24001564/v1_202408020442/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2529993X24001564?idApp=UINPBA00004N"]

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Vol. 42. Issue 7.

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