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Tuberculin reactivity in tuberculous meningitis

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Abstract

Objective: To study tuberculin reactivity in childhood tuberculous meningitis both in clinical and histopathological (HP) context.Methodology: Children with tuberculous meningitis (TBM) were given tuberculin test by Mantoux technique, which was read at the end of 72 hours after the placement of skin test. Histopathological examination of the punch biopsy specimen of the tuberculin test site was performed and histopathological grading of the tuberculin reaction was compared with clinical reaction and clinical parameters.Results: Of the 50 children studied, 68% of them were malnourished and 42% had BCG scar. Tuberculin test was positive in 22 (44%) cases. Spearman analysis showed negative correlation between stage of TBM and the size of tuberculin reaction. BCG status did not affect the size of tuberculin reaction. Histopathological grade of the tuberculin reaction was found to be directly proportional to the size of the tuberculin reaction and it was not affected by the stage of TBM.Conclusion: Tuberculin positivity is low in TBM irrespective of the nutritional status. At least some degree of inflammatory reaction can be seen at the site of tuberculin administration. In tuberculin negative cases, varying grades of cellular response in the absence of clinical induration can be seen in histopathology.

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References

  1. Holden M, Dubin MR, Diamond PH. Frequency of negative intermediate-strength tuberculin sensitivity in patients with active tuberculosis.N Engl J Med 1971; 285: 1506–1059.

    Article  CAS  PubMed  Google Scholar 

  2. Nash DR, Douglass JE. Anergy in active pulmonary tuberculosis: a comparison between positive and negative reactors and an evaluation of 5 TU and 250 TU skin test doses.Chest 1980; 77: 32–37.

    Article  CAS  PubMed  Google Scholar 

  3. Beck JS, Morley SM, Gibbs JHet al. The cellular responses of tuberculosis and leprosy patients and of healthy controls in skin tests to ‘New Tuberculin’ and Leprosin A.Clin Exp Immunol 1986; 64: 484–494.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Ahuja GK, Mohan KK, Prasad K, Behari M. Diagnostic criteria for tuberculous meningitis and their validation.Tuber Lung Dis 1994; 75: 149–152.

    Article  CAS  PubMed  Google Scholar 

  5. Streptomycin in Tuberculosis Trials Committee, Medical Research Council. Streptomycin Treatment of Tuberculous Meningitis.Lancet 1948; 1: 582–586.

    Google Scholar 

  6. Sokal JE. Measurement of delayed skin-test responses.New Eng J Med 1975; 293: 501–502.

    Article  CAS  PubMed  Google Scholar 

  7. Serane TV, Nalini P. Tuberculin reactivity in healthy school children in Pondicherry.Indian J Pediatr 2001; 68: 729–732.

    Article  CAS  PubMed  Google Scholar 

  8. Gibbs JH, Ferguson J, Brown RAet al. Histometric study of the localization of lymphocyte subsets and accessory cells in human Mantoux reactions.J Clin Pathol 1984; 37: 1227–1234.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Seth R, Sharma U. Diagnostic criteria for Tuberculous Meningitis.Indian J Pediatr 2002; 69: 299–303.

    Article  PubMed  Google Scholar 

  10. Farinha NJ, Razali KA, Holzel H, Morgan G, Novelli VM. Tuberculosis of the central nervous system in children: a 20-year survey.J Infect 2000; 41: 61–68.

    Article  CAS  PubMed  Google Scholar 

  11. Gocmen A, Kiper N, Ertan U, Kalayci O, Ozcelik U. Is the BCG test of diagnostic value in tuberculosis.Tuber Lung Dis 1994; 75: 54–57.

    CAS  PubMed  Google Scholar 

  12. Seth V, Kukreja N, Sundaram KR, Malaviya AN. Delayed hypersensitivity after BCG in preschool children in relation to their nutritional status.Indian J Med Res 1981; 74: 392–398.

    CAS  PubMed  Google Scholar 

  13. Elliner JJ. Pleural fluid and peripheral blood lymphocyte function in tuberculosis.Ann Intern Med 1978; 89: 932–933.

    Google Scholar 

  14. Rubin LA, Kurman CC, Fritz MEet al. Soluble interleukin-2 receptors are released from activated human lymphoid cells in vitro.J Immunol 1985; 135: 3172–3177.

    CAS  PubMed  Google Scholar 

  15. Barral-Netto M, Barral A, Santos SBet al. Soluble IL-2 receptor as an agent of serum-mediated suppression in human visceral leishmaniasis.J Immunol 1991; 147: 281–284.

    CAS  PubMed  Google Scholar 

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Correspondence to B. Mahadevan.

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Mahadevan, B., Mahadevan, S., Serane, V.T. et al. Tuberculin reactivity in tuberculous meningitis. Indian J Pediatr 72, 213–215 (2005). https://doi.org/10.1007/BF02859258

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