POLYMERASE CHAIN-REACTION FOR NONINVASIVE DIAGNOSIS OF BRAIN MASS LESIONS CAUSED BY MYCOBACTERIUM-TUBERCULOSIS - REPORT OF 5 CASES IN HUMANIMMUNODEFICIENCY VIRUS-POSITIVE SUBJECTS

To investigate whether the polymerase chain reaction (PCR) on the IS61 10 sequence of Mycobacterium tuberculosis could permit the early and n on-invasive diagnosis of tuberculous brain lesions without meningeal i nvolvement in acquired immunodeficiency virus patients, we examined re trospective cerebrospinal fluid (CSF) samples from five patients diagn osed as having cerebral lesions caused by M. tuberculosis, M. tubercul osis deoxyribonucleic acid was detected in CSF samples obtained from e ach of the patients studied, but in none of the controls, The PCR resu lts coincided with, M. tuberculosis isolation from CSF in two patients , In an additional two subjects, culture for M. tuberculosis on CSF wa s negative, and the diagnosis of central nervous system tuberculosis w as achieved by response to specific therapy, In the last patient the P CR result on CSF was confirmed by isolation of M. tuberculosis from br ain biopsy, Interestingly, in this patient the CSF did not yield M. tu berculosis isolation when cultured, The data show the value of PCR as a potentially useful approach for the early and rapid diagnosis of cer ebral tuberculosis even without meningitis.