Okudera Rena, Hongo Yu, Ishihara Keito, Ito Kanshu, Ikewaki Katsunori, Suzuki Kazushi
Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College.
Rinsho Shinkeigaku. 2023 Oct 25;63(10):661-664. doi: 10.5692/clinicalneurol.cn-001866. Epub 2023 Sep 30.
Tuberculous meningitis (TBM) is a central nervous system infection with a high mortality rate and requires early diagnosis and treatment. Identification of Mycobacterium tuberculosis in the cerebrospinal fluid is of primary importance in the diagnosis of TBM, however, conventional methods have some disadvantages: Rapid results tests such as smear and regular PCR method do not have sufficient diagnostic sensitivity; Nested PCR, which is one of the most sensitive tests, is not available in all facilities; Culture tests require a long period of 4-8 weeks for results. Here we report a case of TBM, diagnosed 14 days earlier than culture test by direct Loop-Mediated Isothermal Amplification (LAMP) method using centrifuged medium of cerebrospinal fluid (day 18) culture. The method we used here is simple, widely available, and considered to be useful for early detection of TBM.
结核性脑膜炎（TBM）是一种中枢神经系统感染，死亡率很高，需要早期诊断和治疗。脑脊液中结核分枝杆菌的鉴定在TBM诊断中至关重要，然而，传统方法存在一些缺点：涂片和常规PCR方法等快速检测结果的测试没有足够的诊断敏感性；嵌套PCR是最敏感的检测方法之一，但并非所有机构都能进行；培养检测需要4至8周的长时间才能得出结果。在此，我们报告一例TBM病例，通过使用脑脊液离心培养基（第18天）培养的直接环介导等温扩增（LAMP）方法，比培养检测提前14天确诊。我们在此使用的方法简单、广泛可用，被认为对TBM的早期检测有用。
