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

• Published in: Basic and clinical neuroscience 2020-09, Vol.11 (5), p.619-630
• Main Authors: Bapat, Prachi R, Shekhawat, Seema D, Husain, Aliabbas A, Dodkey, Renuka S, Daginawala, Hatim F, Singh, Lokendra K, Kashyap, Rajpal S
• Format: Article
• Language: English
• Subjects: Central nervous system; Cerebrospinal fluid; duplex pcr; Meningitis; mycobacterium bovis; Pathogens; Tuberculosis; tuberculous meningitis; Zoonoses
• ISSN: 2228-7442; 2008-126X; 2228-7442
• DOI: 10.32598/bcn.9.10.11.5.803.3

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.