Opportunistic infection in AIDS.
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Biomedical subjects
Publications and source records attributed to Shrinivas.
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Diagnosis of tuberculous meningitis (TBM) is difficult and frustrating. Modified soluble antigen fluorescent antibody (SAFA) test was applied to 40 CSF and 32 serum samples from 48 patients to assess the efficacy of this test in the rapid diagnosis of TBM. Using this test, false negative results were obtained in 41.6% and 40% of CSF and serum samples. False positive results were obtained in 22.2% and 26.7% of CSF and serum samples respectively. SAFA test was not found to be helpful in the sero-diagnosis of TBM. It is suggested that the best immunodiagnostic test for TBM will be to demonstrate the presence of antigen, antibody and antigen-antibody complex in the CSF for M. tuberculosis.
Cell-mediated immune response was investigated in fifteen patients with miliary tuberculosis. Delayed hypersensitivity skin test with "recall" antigens PPD and SKSD was positive in two and one patients respectively. An irritant dose of DNCB failed to induce non-specific inflammatory response in the skin of thirteen patients and the same patients also did not develop contact sensitivity to DNCB. Leucocyte migration test in the presence of Mycobacterium tuberculosis was also negative in eight of eleven patients studied. The proportion of E rosette-forming cells was found to be significantly depressed, though the proportion of EAC rosette-forming cells did not show any abnormality. On repeat skin tests in five patients after 3 months of chemotherapy and clinical improvement four showed a positive PPD and DNCB response. It was concluded that there is a marked degree of secondary immunodeficiency in miliary tuberculosis.
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