T-cell-based assays on cerebrospinal fluid and PBMCs for rapid diagnosis of TB meningitis in non-HIV patients.

Recently, two studies have shown that an ELISPOT assay using mononuclear cells (MCs) compartmentalised in the cerebrospinal fluid (CSF) is an accurate and rapid rule-out or rule-in test for tuberculosis meningitis (TBM) in conjunction with other rapid tests [1, 2]. However, these two studies had limitations: the majority (94%) of enrolled patients were infected with HIV in one study [2], and the CSF-MC ELISPOT assay was performed on a relatively small number of patients in the other [1]. This study builds on our earlier publication [1] and evaluates the clinical utility for the diagnosis of TBM of simultaneous testing with the peripheral blood mononuclear cell (PBMC) and CSF-MC ELISPOT assays in a larger number of non-HIV-infected patients, by using the standardised diagnostic criteria for TBM [3].