Pyrosequencing to resolve discrepant Xpert MTB/RIF and Mycobacterial Growth Indicator Tube 960

Ajbani, Kanchan; Kazi, Mubin; Tornheim, Jeffrey A.; Naik, Swapna; Soman, Rajeev; Shetty, Anjali; Rodrigues, Camilla

doi:10.4103/lungindia.lungindia_71_17

Cited by 7 publications

(1 citation statement)

References 12 publications

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“…Limited diagnostic sensitivity (55–80%), difficult interpretation of rifampicin resistance in cases of “very low load,” and the availability of Xpert Ultra preclude its use in the diagnosis of TBM and SCTB. [ 53 ]…”

Section: Olecular T Estsmentioning

confidence: 99%

Tuberculosis of the spinal cord

Manesh

Garg

Radhakrishnan

et al. 2023

Ann Indian Acad Neurol

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Tuberculosis involving the spinal cord is associated with high mortality and disabling long-term sequelae. Although tuberculous radiculomyelitis is the most frequent complication, pleomorphic clinical manifestations exist. Diagnosis can be challenging among patients with isolated spinal cord tuberculosis due to diverse clinical and radiological presentations. The principles of management of tuberculosis of the spinal cord are primarily derived from, and dependent upon, trials on tuberculous meningitis (TBM). Although facilitating mycobacterial killing and controlling host inflammatory response within the nervous system remain the primary objectives, several unique features require attention. The paradoxical worsening is more frequent, often with devastating outcomes. The role of anti-inflammatory agents such as steroids in adhesive tuberculous radiculomyelitis remains unclear. Surgical interventions may benefit a small proportion of patients with spinal cord tuberculosis. Currently, the evidence base in the management of spinal cord tuberculosis is limited to uncontrolled small-scale data. Despite the gargantuan burden of tuberculosis, particularly in lower and middle-income countries, large-scale cohesive data are surprisingly sparse. In this review, we highlight the varied clinical and radiological presentations, performance of various diagnostic modalities, summarize data on the efficacy of treatment options, and propose a way forward to improve outcomes in these patients.

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Section: Olecular T Estsmentioning

confidence: 99%