結核菌群核酸増幅同定検査 (MTD) により迅速診断が可能であった結核性髄膜炎の2例

抄録

The Gen-Probe^® Amplified Mycobacterium Tuberculosis Direct Test (MTD) is a rapid direct specimen assay method for identification of M. tuberculosis by amplification of ribosomal RNA and detection of the product with a specific chemiluminescent DNA probe.
We report two cases of tuberculous meningitis which were positive in the MTD. Since the cerebrospinal fluid showed negative smears and positive cultures in both cases, we could diagnose tuberculous meningitis by MTD about 2 months earlier than by conventional smear and culture methods.
In one patient, the fever didn't subside immediately after staring chemotherapy. In the other patient, an intracerebral focus appeared after administration of antituberculosis drugs. However, we did not hesitate to continue the therapy because of the MTD positive findings.
MTD is considered to be a very useful test especially in diseases like tuberculous meningitis which need rapid diagnosis and rapid therapy, and is useful for improvement of convalescence and is economical.