Amplification of IS6110 sequence for detection of Mycobacterium tuberculosis complex in HIV-negative patients with fever of unknown origin (FUO) and evidence of extrapulmonary disease
K. Ritis et al., Amplification of IS6110 sequence for detection of Mycobacterium tuberculosis complex in HIV-negative patients with fever of unknown origin (FUO) and evidence of extrapulmonary disease, J INTERN M, 248(5), 2000, pp. 415-424
Citations number
27
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Objectives. Extrapulmonary tuberculosis (TB) constitutes the main cause of
classic fever of unknown origin (FUO) in many populations. The aim of this
study was to improve the diagnostic field of the disease using a nested pol
ymerase chain reaction (PCR) assay, specific for the IS6110 insertion eleme
nt of Mycobacterium tuberculosis complex, in order to achieve a more timely
diagnosis and treatment.
Setting. Twenty-four, HIV-negative classic FUO patients who were admitted t
o the Regional Hospital of Alexandroupolis between April 1997 and July 1999
.
Subjects and design. The above patients were considered as putative extrapu
lmonary TB after 3 weeks of in-patient investigation and underwent exhausti
ve examination for diagnosis of the disease. For this purpose peripheral bl
ood patients, as well as from damaged tissues, and analysed by both PCR and
conventional methods. Anti-tuberculous treatment was initiated in 16 out o
f 24 patients and the response to this regimen was considered as the final
criterion for diagnosis of tuberculosis.
Results. Extrapulmonary TB was established in 11 patients. The PCR-based me
thodology, when applied to samples derived from bone marrow aspirations and
suspected damaged tissues, was able to diagnose 10 of them, whereas the co
nventional methods were able to detect only two.
Conclusions. Our results confirm the diagnostic value of molecular detectio
n of M. tuberculosis in cases of FUO, thus supporting the application of PC
R in tissue samples suspected of bacillus infection. Furthermore, our studi
es demonstrate that bone marrow aspiration specimens constitute an alternat
ive, easy, safe and reliable source for such PCR analysis.