Frequency-pulsed electron capture gas-liquid chromatography and the tryptophan color test for rapid diagnosis of tuberculous and other forms of lymphocytic meningitis

Abstract

A total of 260 samples of cerebrospinal fluid received from Egypt, the United States, Canada, and South America were examined by frequency-pulsed electron capture gas-liquid chromatography (FPEC-GLC) for tuberculous and other forms of lymphocytic meningitis. Thirty-four of the specimens were culture positive for M. tuberculosis, and four cerebrospinal fluid specimens of herpes meningitis were established by immunological techniques. The compound, 3-(2'-ketohexyl)-indoline, was found in about 60% of the Egyptian tuberculous specimens and none of the culture-positive American specimens. the carboxylic and hydroxy acid FPEC-GLC profiles were used effectively in conjunction with other clinical data to make the diagnosis even in the absence of 3-(2'-ketohexyl)indoline. Herpes meningitis and mixed infections of Myeobacterium tuberculosis-herpes, M. tuberculosis-leptospira, and M. tuberculosis-Haemophilus influenzae produced profiles different from each other and from pure culture cases. The color test for tuberculous meningitis was evaluated, and free tryptophan was eliminated as the source of color reaction. Indications are that 3-(2'-ketohexyl)indoline, in most cases, is not responsible for the positive color reaction. Differences in the clinical and FPEC-GLC data obtained from samples from different geographical regions are discussed.