Laboratory confirmation of TBM may be achieved by
several means, each with its own drawbacks. The gold
standard for many years was, and indeed still remains, the
detection of tubercle bacilli in the CSF by microscopy and/or
culture. Direct microscopic examination of the CSF, however,
is notoriously sensitive to sample volume and time spent
searching for acid-alcohol fast bacilli. Despite improvements
in technology, culture takes too long for early diagnosis. Its
value is in the subsequent confirmation of TBM in patients
who have started anti-tuberculous chemotherapy solely on
clinical grounds.
Laboratory confirmation of TBM may be achieved byseveral means, each with its own drawbacks. The goldstandard for many years was, and indeed still remains, thedetection of tubercle bacilli in the CSF by microscopy and/orculture. Direct microscopic examination of the CSF, however,is notoriously sensitive to sample volume and time spentsearching for acid-alcohol fast bacilli. Despite improvementsin technology, culture takes too long for early diagnosis. Itsvalue is in the subsequent confirmation of TBM in patientswho have started anti-tuberculous chemotherapy solely onclinical grounds.
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