Sensitive enzyme immunoassay for early diagnosis of tuberculous meningitis.

Cerebrospinal fluid from patients with tuberculous, pyogenic, and viral meningitis, as well as from appropriate control individuals, were assayed for immunoglobulin G and immunoglobulin M antibody activity to Mycobacterium bovis BCG by an enzyme-linked immunosorbent assay. BCG linked covalently to plastic disks served as the antigen in a classical indirect enzyme-linked immunosorbent assay. A significant difference was found between the tuberculous meningitis group and the nontuberculous meningitis and control groups. All samples from the tuberculous meningitis group gave a positive reaction, and none of the known negative samples gave false-positive reactions. Because of its sensitivity, specificity, and predictive value, this test may be useful in the early diagnosis of tuberculous meningitis.