International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Challenges and Limitations of Conventional Diagnostic Techniques in Central Nervous System Tuberculosis

Author(s) Sahil Wilson, Dr. Shri Dhar Singh
Country India
Abstract The extrapulmonary form of tuberculosis (EPTB) is one of the most devastating and life-threatening complications, with central nervous system tuberculosis (CNS-TB) causing high mortality and leaving neurological sequelae. The timely diagnosis is a key factor in patient's survival and therapeutic response. In spite of these, there are significant limitations in the sensitivity, specificity and turnaround time of the conventional diagnostic techniques such as smear microscopy of CSF, culture methods, biochemical analysis and radiological imaging. Due to the paucibacillary nature of CNS-TB, clinical overlap with other neurological diseases, and delayed laboratory confirmation, misdiagnosis and late diagnosis of CNS-TB occur. Although smear microscopy was reported to be less sensitive because of low bacillary load in CSF, culture techniques was reported to be the gold standard, but it was time consuming and result in delayed results that are not suitable for urgent clinical management. Likewise, imaging does not have any disease specific characteristics and may simulate fungal, bacterial, neoplastic or inflammatory lesions. Diagnostic challenges are exacerbated by the lack of sufficient laboratory services, availability of high-level diagnostic facilities and technical expertise, in resource-constrained environments. The major limitations of current methods of diagnosis in CNS-TB are critically reviewed and the implications for clinical decision making are emphasized. The importance of developing the diagnostic algorithms that combine rapid molecular technologies with standard ones to optimize early diagnosis and reduce disease burden is also discussed.
Keywords Central nervous system tuberculosis, tuberculous meningitis, conventional diagnostics, smear microscopy, cerebrospinal fluid culture, diagnostic limitations, CNS-TB.
Published In Volume 7, Issue 1, January-February 2025
Published On 2025-01-10
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E-ISSN 2582-2160
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