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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Vivekanandan, Renuga Horowitz, Edward A. Vallabhajosyula, Saraschandra |
| Description | Author Affiliation: Vallabhajosyula S ( Department of Internal Medicine, Alegent-Creighton University Medical Center, Creighton University School of Medicine, Omaha NE, USA.); Vivekanandan R ( Division of Infectious Diseases, Department of Internal Medicine, Alegent-Creighton University Medical Center, Creighton University School of Medicine, Omaha NE, USA.); Horowitz EA ( Division of Infectious Diseases, Department of Internal Medicine, Alegent-Creighton University Medical Center, Creighton University School of Medicine, Omaha NE, USA.) |
| Abstract | Incidence of tuberculosis in Nebraska is 1.9/100,000 people. Tuberculous meningitis is rare and comprises 1% of extrapulmonary tuberculosis. An elderly Caucasian man presented with fever, headache, altered mentation and a history of tick bite. Cerebrospinal fluid (CSF) analysis showed negative cultures and the patient was treated empirically for tickborne illness. Forty-five days later, CSF nucleic acid amplification test (NAAT) was positive for tuberculosis. On readmission, repeat neurological examination and CSF analysis were benign and the patient was not offered antituberculous treatment. Genotype investigation of the culture and NAAT specimen by the Center for Disease Control confirmed laboratory contamination. The literature reports an incidence of 2-4% for false-positive tuberculosis cultures. Contaminated devices, clerical errors and laboratory errors have been implicated. Laboratory contamination results in smear-negative culture-positive cases. Epidemiological investigation with genotype testing is confirmatory. Detailed clinical assessment with good clinical and laboratory communication and frequent laboratory surveillance is advocated to mitigate these cases. |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Volume Number | 2014 |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Diagnostic Errors Equipment Contamination Mycobacterium Tuberculosis Genetics Tuberculosis, Meningeal Diagnosis False Positive Reactions Genotype Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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