학술논문
The diagnostic utility of the 'Thwaites’ system' and 'lancet consensus scoring system' in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients
Document Type
article
Author
Tarek Sulaiman; Sai Medi; Hakan Erdem; Seniha Senbayrak; Derya Ozturk-Engin; Asuman Inan; Rok Civljak; Mihai Nechifor; Ayhan Akbulut; Alexandru Crisan; Muge Ozguler; Mustafa Namiduru; Branislava Savic; Olga Dulovic; Filiz Pehlivanoglu; Gonul Sengoz; Kadriye Yasar; Ayse Seza Inal; Emine Parlak; Isik Somuncu Johansen; Ebru Kursun; Mehmet Parlak; Emel Yilmaz; Gulden Yilmaz; Hanefi Cem Gul; Oral Oncul; Soline Siméon; Pierre Tattevin; Aysegul Ulu-Kilic; Selma Alabay; Bojana Beovic; Melanie Catroux; Yves Hansmann; Arjan Harxhi; Alper Sener; Hacer Deniz Ozkaya; Yasemin Cağ; Canan Agalar; Haluk Vahaboglu; Berna Kaya Ugur; Rodrigo Hasbun
Source
BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-11 (2020)
Subject
Language
English
ISSN
1471-2334
Abstract
Abstract Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The “Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P