Table 1 Overview of uniform research case definition criteria18 in confirmed, probable and possible TBM cases.
From: High rate of drug resistance among tuberculous meningitis cases in Shaanxi province, China
Diagnostic categories and criteria (Maximum category score) | Diagnostic score | Confirmed n = 25 (%) | Probable n = 84 (%) | Possible n = 239(%) |
|---|---|---|---|---|
Clinical (Maximum score = 6) | ||||
CNS symptom duration >5 days | 4 | 25 (100.0) | 67 (79.8) | 159 (66.5) |
Other symptoms suggestive of TB a | 2 | 19 (76.0) | 43 (51.2) | 31 (13.0) |
Recent close contact with an infectious TB case b or positive TST/IGRA | 2 | 11 (44.0) | 9 (10.7) | 5 (2.1) |
Focal neurological deficit c | 1 | 14 (56.0) | 34 (40.5) | 95 (39.7) |
Cranial nerve palsy | 1 | 4 (16.0) | 5 (6.0) | 24 (10.0) |
Altered consciousness | 1 | 18 (72.0) | 45 (53.6) | 108 (45.2) |
CSF (Maximum score = 4) | ||||
Clear appearance | 1 | 18 (72.0) | 77 (91.7) | 221(92.5) |
Cells: 10–500 per μl | 1 | 24 (96.0) | 72 (85.7) | 210 (87.9) |
Lymphocytic predominance (>50%) | 1 | 14 (56.0) | 61 (72.6) | 192 (80.3) |
Protein concentration greater than 1 g/L | 1 | 17 (68.0) | 54 (64.3) | 72 (30.1) |
Glucose concentration <2.2 mmol/L | 1 | 22 (88.0) | 52 (61.9) | 53 (22.2) |
CNS imaging (Maximum score = 6) | ||||
Hydrocephalus | 1 | 11 (44.0) | 22 (26.2) | 27 (11.3) |
Basal meningeal enhancement | 2 | 9 (36.0) | 18 (21.4) | 23 (9.6) |
Tuberculoma | 2 | 3 (12.0) | 1 (1.2) | 0 |
Infarct | 1 | 6 (24.0) | 6 (7.1) | 11 (4.6) |
Pre-contrast basal hyperdensity | 2 | 4 (16.0) | 12 (14.3) | 8 (3.3) |
TB elsewhere (Maximum score = 4) | ||||
CXR suggestive (PTB = 2; miliary TB = 4) | 2/4 | 19 (76.0) | 43 (51.2) | 31(13.0) |
Other imaging suggestive of TB | 2 | 11 (44.0) | 9 (10.7) | 5 (2.1) |
Positive AFB, M. tuberculosis or NAAT from extra-neural specimen | 4 | 4 (16.0) | 5 (6.0) | 2 (0.8) |
Score; median (range) | 20 max | 13 (6–20) | 12 (10–18) d | 6 (6–11) e |
