{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T11:41:28Z","timestamp":1778326888151,"version":"3.51.4"},"reference-count":49,"publisher":"Walter de Gruyter GmbH","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_dx-2022-0102_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      The definitive diagnosis of tuberculous meningitis (TBM) is achieved by identifying\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      (MTb) in cerebrospinal fluid (CSF); however, diagnostic confirmation is difficult due to the inability of\u00a0current tests for an effective diagnosis. Our objective was to retrospectively assess the characteristics of CSF lactate (CSF-LA) as an adjunct biomarker in the diagnosis of TBM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2022-0102_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>608 CSF laboratory reports were assessed. Of these, 560 had clinically suspected TBM. These were classified as definite (n=36), probable (23), possible (278),\u00a0or non-TBM (223) according to the international consensus TBM case definitions. An additional 48 CSF samples were negative controls with normal CSF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2022-0102_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Against a reference standard of definite TBM, the cut-off value for CSF-LA was 4.0\u00a0mmol\/L, the area under the ROC curve was 0.88 (95% CI, 0.82\u20130.94; p=0.0001), sensitivity was 69%, specificity 90%, negative predictive value 98%. These diagnostic parameters decreased when calculated against those of the other categories of TBM. CSF-LA exhibited high specificity, efficiency, negative predictive value, and clinical utility index in all the groups studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_dx-2022-0102_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CSF-LA is a useful diagnostic marker to rule out TBM when associated with conventional microbiology tests, nucleic acid amplification assays, and clinical algorithms, particularly in endemic areas.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/dx-2022-0102","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T14:45:15Z","timestamp":1670424315000},"page":"130-139","source":"Crossref","is-referenced-by-count":5,"title":["Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis"],"prefix":"10.1515","volume":"10","author":[{"given":"S\u00e9rgio Monteiro","family":"de Almeida","sequence":"first","affiliation":[{"name":"Virology Section Clinical Pathology Laboratory Hospital De Cl\u00ednicas , Federal University of Paran\u00e1 , Curitiba , Brazil"},{"name":"CSF Section Clinical Pathology Laboratory Hospital De Cl\u00ednicas , Federal University of Paran\u00e1 , Curitiba , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gislene B.","family":"Kussen","sequence":"additional","affiliation":[{"name":"Bacteriology Section, Clinical Pathology Laboratory, Hospital De Cl\u00ednicas , Federal University of Paran\u00e1 , Curitiba , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura L.","family":"Cogo","sequence":"additional","affiliation":[{"name":"Bacteriology Section, Clinical Pathology Laboratory, Hospital De Cl\u00ednicas , Federal University of Paran\u00e1 , Curitiba , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keite","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Bacteriology Section, Clinical Pathology Laboratory, Hospital De Cl\u00ednicas , Federal University of Paran\u00e1 , Curitiba , Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"2025121206463817393_j_dx-2022-0102_ref_001","unstructured":"Wilder-Smith, EP. 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