Immunologic Diagnosis of Neurotuberculosis

Abstract

Tuberculosis (TB) is one of the most prevalent infectious diseases in the world, particularly in developing countries. The high incidence and mortality of TB in these countries mainly resides in the limited financial resources, the emergence of multiresistant strains and the spread of HIV infections. The key element for controlling TB is a rapid and early diagnosis which ensures the correct treatment and eradication of the infection source in the community. Current strategies for the development of a rapid and accurate diagnosis address 3 major objectives: improving the present diagnostic tools through better knowledge, developing new tests and increasing the accessibility to such diagnostic possibilities (Who Strategic Directions, 2006). The gold standard of diagnosis in TB is the identification of mycobacteria in the pathologic product using acid-fast smear microscopy and mycobacterial culture. Nevertheless the bacteriologic diagnosis is presently inefficient due to increasing number of smear-negative TB forms. This has led to the development of various complementary diagnostic methods such immunologic assays. The aim of the present chapter is to outline the literature data on the importance of the immunologic diagnosis in neurotuberculosis, a lethal localization of TB. It presents the current immunological assays and their practical value in the diagnosis of neurotuberculosis as complementary methods.