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1
Girgis NI, Sultan Y, Farid Z, Mansour MM, Erian MW, Hanna LS, Mateczun AJ, 1998. Tuberculosis meningitis, Abbassia Fever Hospital–Naval Medical Research Unit No. 3–Cairo, Egypt, from 1976 to 1996. Am J Trop Med Hyg 58 :28–34.
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2
Hosoglu S, Geyik MF, Balik I, Aygen B, Erol S, Aygencel TG, Mert A, Saltoglu N, Dokmetas I, Felek S, Sunbul M, Irmak H, Aydin K, Kokoglu OF, Ucmak H, Altindis M, Loeb M, 2002. Predictors of outcome in patients with tuberculous meningitis. Int J Tuberc Lung Dis 6 :64–70.
-
3
Fallon RJ, Kennedy DH, 1981. Treatment and prognosis in tuberculous meningitis. J Infect 3 :39–44.
-
4
Humphries MJ, Teoh R, Lau J, Gabriel M, 1990. Factors of prognostic significance in Chinese children with tuberculous meningitis. Tubercle 71 :161–168.
-
5
Misra UK, Kalita J, Srivastava M, Mandal SK, 1996. Prognosis of tuberculous meningitis: a multivariate analysis. J Neurol Sci 137 :57–61.
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6
Kalita J, Misra UK, 1999. Outcome of tuberculous meningitis at 6 and 12 months: a multiple regression analysis. Int J Tuberc Lung Dis 3 :261–265.
-
7
Lincoln EM, Sordillo VR, Davies PA, 1960. Tuberculous meningitis in children. A review of 167 untreated and 74 treated patients with special reference to early diagnosis. J Pediatr 57 :807–823.
-
8
Anderson NE, Willoughby EW, 1987. Chronic meningitis without predisposing illness–a review of 83 cases. Q J Med 63 :283–295.
-
9
Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J, 2000. Tuberculous meningitis. J Neurol Neurosurg Psychiatry 68 :289–299.
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10
Thwaites GE, Tran TH, 2005. Tuberculous meningitis: many questions, too few answers. Lancet Neurol 4 :160–170.
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11
Thwaites GE, Chau TT, Stepniewska K, Phu NH, Chuong LV, Sinh DX, White NJ, Parry CM, Farrar JJ, 2002. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 360 :1287–1292.
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12
Sunbul M, Atilla A, Esen S, Eroglu C, Leblebicioglu H, 2005. Thwaites’ diagnostic scoring and the prediction of tuberculous meningitis. Med Princ Pract 14 :151–154.
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13
Wilson EB, 1927. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc 22 :209–212.
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Validation of a Diagnostic Algorithm for Adult Tuberculous Meningitis
M. Estee Török
M. Estee Török
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Ho Dang Trung Nghia
Ho Dang Trung Nghia
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Tran Thi Hong Chau
Tran Thi Hong Chau
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Nguyen Thi Hoang Mai
Nguyen Thi Hoang Mai
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Guy E. Thwaites
Guy E. Thwaites
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Kasia Stepniewska
Kasia Stepniewska
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Jeremy J. Farrar
Jeremy J. Farrar
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam; Centre for Medical Microbiology and Infection, Imperial College, London, United Kingdom; Wellcome Mahidol Oxford Tropical Medicine Research Programme, Bangkok, Thailand; University of Oxford, Centre for Clinical Vaccinology and Tropical Medicine, United Kingdom
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Tuberculous meningitis (TBM) remains difficult to diagnose. We prospectively evaluated a diagnostic algorithm for TBM in 205 HIV-negative patients with meningitis and a low CSF glucose. Patients were classified as having TBM or bacterial meningitis (BM) by two diagnostic methods: logistic regression method (LRM) and classification and regression tree (CART). We performed analyses of TBM versus BM and TBM versus non-TBM in all patients and in patients with microbiologically confirmed diagnoses. Diagnostic sensitivities for TBM were 99% (LRM) and 87% (CART). For BM, diagnostic sensitivities were 81.5% (LRM) and 86.5% (CART) in the primary analysis and 86.5% (LRM) and 74% (CART) in the secondary analysis. In microbiologically confirmed cases, similar rates were achieved. These figures are superior to microbiological confirmation rates in routine laboratories and support the use of this algorithm in high-prevalence TB settings with limited diagnostic facilities. Validation in an HIV-endemic setting is required.
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-
1
Girgis NI, Sultan Y, Farid Z, Mansour MM, Erian MW, Hanna LS, Mateczun AJ, 1998. Tuberculosis meningitis, Abbassia Fever Hospital–Naval Medical Research Unit No. 3–Cairo, Egypt, from 1976 to 1996. Am J Trop Med Hyg 58 :28–34.
-
2
Hosoglu S, Geyik MF, Balik I, Aygen B, Erol S, Aygencel TG, Mert A, Saltoglu N, Dokmetas I, Felek S, Sunbul M, Irmak H, Aydin K, Kokoglu OF, Ucmak H, Altindis M, Loeb M, 2002. Predictors of outcome in patients with tuberculous meningitis. Int J Tuberc Lung Dis 6 :64–70.
-
3
Fallon RJ, Kennedy DH, 1981. Treatment and prognosis in tuberculous meningitis. J Infect 3 :39–44.
-
4
Humphries MJ, Teoh R, Lau J, Gabriel M, 1990. Factors of prognostic significance in Chinese children with tuberculous meningitis. Tubercle 71 :161–168.
-
5
Misra UK, Kalita J, Srivastava M, Mandal SK, 1996. Prognosis of tuberculous meningitis: a multivariate analysis. J Neurol Sci 137 :57–61.
-
6
Kalita J, Misra UK, 1999. Outcome of tuberculous meningitis at 6 and 12 months: a multiple regression analysis. Int J Tuberc Lung Dis 3 :261–265.
-
7
Lincoln EM, Sordillo VR, Davies PA, 1960. Tuberculous meningitis in children. A review of 167 untreated and 74 treated patients with special reference to early diagnosis. J Pediatr 57 :807–823.
-
8
Anderson NE, Willoughby EW, 1987. Chronic meningitis without predisposing illness–a review of 83 cases. Q J Med 63 :283–295.
-
9
Thwaites G, Chau TT, Mai NT, Drobniewski F, McAdam K, Farrar J, 2000. Tuberculous meningitis. J Neurol Neurosurg Psychiatry 68 :289–299.
-
10
Thwaites GE, Tran TH, 2005. Tuberculous meningitis: many questions, too few answers. Lancet Neurol 4 :160–170.
-
11
Thwaites GE, Chau TT, Stepniewska K, Phu NH, Chuong LV, Sinh DX, White NJ, Parry CM, Farrar JJ, 2002. Diagnosis of adult tuberculous meningitis by use of clinical and laboratory features. Lancet 360 :1287–1292.
-
12
Sunbul M, Atilla A, Esen S, Eroglu C, Leblebicioglu H, 2005. Thwaites’ diagnostic scoring and the prediction of tuberculous meningitis. Med Princ Pract 14 :151–154.
-
13
Wilson EB, 1927. Probable inference, the law of succession, and statistical inference. J Am Stat Assoc 22 :209–212.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 646 | 524 | 23 |
| Full Text Views | 426 | 9 | 0 |
| PDF Downloads | 192 | 10 | 0 |