Cartridge based nucleic acid amplification test negative in highly suspected case of tuberculosis: a case report
DOI:
https://doi.org/10.18203/2320-6012.ijrms20200502Abstract
Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.
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References
World Health Organization. Global tuberculosis report 2016. World Health Organization. Available at: https://apps.who.int/iris/handle/10665/250441. Assessed 20 December 2019.
Central TB division. Directorate General of Health services, Ministry of Health and Family Welfare, Government of India, New Delhi; 2011. TB division: Revised National TB control Programme Annual Status Report. Available at: http://tbcindia.nic.in/WriteReadData/TB%20India%202017.pdf . Assessed 18 December 2019.
Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuber Res Dis (Seoul). 2015 Apr;78(2):47-55.
Arora D, Jindal N, Bansal R, Arora S. Rapid detection of Mycobacterium tuberculosis in sputum samples by Cepheid Xpert assay: a clinical study. J Clini Diagnos Res: JCDR. 2015;9(5):DC03.
Dewan R, Anuradha S, Khanna A, Garg S, Singla S, Ish P, et al. Role of cartridge-based nucleic acid amplification test (CBNAAT) for early diagnosis of pulmonary tuberculosis in HIV. JIACM. 2015;16(2):114-7.
Amplification AR. Technology for Rapid and Simultaneous Detection of Tuberculosis and Rifampicin Resistance: Xpert MTB/RIF Assay for the Diagnosis of Pulmonary and Extrapulmonary TB in Adults and Children: Policy Update. Geneva: World Health Organization. 2013. Available at: https://apps.who.int/iris/bitstream/handle/10665/112472/9789241506335_eng.pdf;jsessionid=C3A72D9C80BE831C6FF4AB1F50DBC376?sequence=1. Assessed 10 December 2019.
Steingart KR, Sohn H, Schiller I, Kloda LA, Boehme CC, Pai M, et al. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Systema Rev. 2013(1).
WHO. Automated Real Time Nucleic Acid Amplification Technology for Rapid and Simultaneous Detection of Tuberculosis and Rifampicin Resistance: Xpert MTB/RIF Assay for the Diagnosis of Pulmonary and Extrapulmonary TB in Adults and Children: Policy update. World Heal Organ. 2013:1-79.
World Health Organization. Xpert MTB/RIF implementation manual: technical and operational ‘how-to’: practical considerations; 2014. Available at: http://www.who.int/tb/publications/xpert_implem _manual/en/. Assessed 14 December 2019.
Sahana KS, Prabhu AS, Saldanha PR. Usage of Cartridge Based Nucleic Acid Amplification Test (CB-NAAT/GeneXpert) test as diagnostic modality for pediatric tuberculosis; case series from Mangalore, South India. J Clini Tuberculosis Other Mycobacterial Dis. 2018;11:7-9.
Sharma SK, Kohli M, Yadav RN, Chaubey J, Bhasin D, Sreenivas V, et al. Evaluating the diagnostic accuracy of Xpert MTB/RIF assay in pulmonary tuberculosis. PloS One. 2015;10(10):1-9.