Xpert Ultra and TB meningitis: advancing towards policy revision?

Tuberculous meningitis (TBM) is a devastating condition with high mortality and survivors are often left with severe neurological sequelae. HIV-associated TBM can have mortality rates exceeding 60% (1). Early diagnosis and initiation of treatment is critical for survival. Unfortunately the diagnosis of TBM can be more of an art than a science, as a recent report in the Lancet by Bahr and colleagues highlights. There is currently no diagnostic test with high sensitivity and specificity.