Table 5.
Methods to increase mycobacterial yield of CSF smear examination29
| Examine the deposit on centrifugation of a 10 ml CSF sample exclusively for the staining and culture of M.tuberculosis. |
| Examine CSF before or shortly after starting antituberculosis drugs |
| Centrifuge at high relative centrifugal force (3000g) for 20 minutes |
| Remove all but 200ìl of supernatant (which can be used for biochemical tests) and vigorously resuspend deposit. |
| Dry two drops of deposit onto a microscope slide (the second directly on top of the first) covering a diameter of less than 1cm |
| Ziehl-Neelsen stain the dried deposit (auromine staining alone is not recommended). |
| Careful examination of the slide for at least 10 minutes starting from the areas of highest cellularity and extend the examination to at least 20 minutes if TBM is strongly suspected. |
| Examine several CSF samples over a few days |