Clinical scoring systems for diagnosing tuberculous meningitis: A systematic review

doi:10.5492/wjccm.v15.i1.110763

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World Journal of Critical Care Medicine

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2220-3141

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World J Crit Care Med. Mar 9, 2026; 15(1): 110763
Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.110763

Table 2 Overview of scores with external validation

Ref.	Sensitivity (%)	Specificity (%)	Country of external validation population	Clinical criteria	Laboratory criteria	Microbiological/histopathological criteria	Radiological criteria
Thwaites et al[31], 2002	Cut off of ≤ 3.5: TBM vs non-TBM: 78.0	Cut off of ≤ 3.5: TBM vs non-TBM: 63.0	Malawi	√	√	X	X
	TBM vs PM: 95.0	TBM vs PM: 23.5	Pakistan
	Cut off of ≤ 4: TBM vs non-TBM: 78.0-100	Cut off of ≤ 4: TBM vs non-TBM: 40.8-43.0	Malawi, Turkey, Qatar
	TBM vs BME: 95.8	TBM vs BME: 0.680	Turkey
	TBM vs PM: 96.0	-	India
	TBM vs BM: 95.8-98.2	TBM vs BM: 43.6-87.9	China, Turkey, India
Marais et al[32], 2010	Cut off of ≥ 6: TBM vs non-TBM: 66.7-100	Cut off of ≥ 6: TBM vs non-TBM: 48.7-85.5	Brazil, Turkey, China, Qatar	√	√	√	√
	TBM vs BM: 93.0-97.0	TBM vs BM: 56.0-68.0	China
	TBM vs BME: 96.8	TBM vs BME: 3.06	Turkey
	Cut off of ≥ 8: TBM vs non-TBM: 84.9	Cut off of ≥ 8: TBM vs non-TBM: 77.2	Brazil
	Cut off of ≥ 10: TBM vs non-TBM: 100	Cut off of ≥ 10: TBM vs non-TBM: 40.8	Brazil
Hristea et al[33], 2012¹	Cut off of ≥ 6: TBM vs non-TBM: 100	Cut off of ≥ 6	Turkey	√	√	X	X
	TBM vs VM: 96.7	TBM vs VM: 81.1	Romania
	TBM vs CM: 86.6	TBM vs CM: 27.7	Romania
	Cut off of ≥ 9: TBM vs VM: 51.6	Cut off of ≥ 9: TBM vs VM: 100	Romania
Kumar et al[34], 1999¹	Cut off of ≥ 3: TBM vs non-TBM: 37.0	Cut off of ≥ 3: TBM vs non-TBM: 58.1	India	√	√	X	X

¹Validated in the paediatric population.

TBM: Tuberculous meningitis; non-TBM: Non-tuberculous meningitis; BME: Bacterial meningoencephalitis; BM: Bacterial meningitis; VM: Viral meningitis; CM: Cryptococcal meningitis; PM: Pyogenic meningitis.

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Citation: Teo E, Kung K, Chen S, See KC. Clinical scoring systems for diagnosing tuberculous meningitis: A systematic review. World J Crit Care Med 2026; 15(1): 110763
URL: https://www.wjgnet.com/2220-3141/full/v15/i1/110763.htm
DOI: https://dx.doi.org/10.5492/wjccm.v15.i1.110763

Teo E, Kung K, Chen S, See KC. Clinical scoring systems for diagnosing tuberculous meningitis: A systematic review. World J Crit Care Med 2026; 15(1): 110763 [PMID: 41883759 DOI: 10.5492/wjccm.v15.i1.110763]

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