Rapid diagnosis of Mycobacterium tuberculosis meningitis by enumeration of cerebrospinal fluid antigen-specific T-cells

Int J Tuberc Lung Dis. 2008 Jun;12(6):651-7.


Setting: Hospital in-patients with suspected tuberculous meningitis (TBM), predominantly in India.

Objective: To determine whether interferon-gamma (IFN-gamma) secreting Mycobacterium tuberculosis antigen-specific T-cells are present in the cerebrospinal fluid (CSF) of patients with TBM and to evaluate the feasibility of CSF enzyme-linked immunospot (ELISpot) for the diagnosis of active TBM.

Design: Prospective blinded hospital-based study.

Results: The overnight ELISpot assay detected M. tuberculosis antigen-specific IFN-gamma secreting T-cells in CSF from nine of 10 prospectively recruited patients with TBM, and zero of seven control patients with meningitis of other aetiology. This corresponds to a diagnostic sensitivity of 90% (95%CI 56-100) and specificity of 100% (95%CI 59-100).

Conclusion: This pilot study demonstrates proof-of-principle for a new T-cell-based diagnostic test for TBM which is rapid, sensitive and specific.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antigens, Bacterial
  • Child
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Female
  • Humans
  • Interferon-gamma / metabolism
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • T-Cell Antigen Receptor Specificity
  • Tuberculosis, Meningeal / diagnosis*


  • Antigens, Bacterial
  • Interferon-gamma