A 23-year-old female presents with a history of fever and
being generally unwell of several weeks duration. She also gave a history of
headaches. About a week prior to admission she had suffered a seizure.
On examination she was febrile and drowsy. There were
white plaques noted in her buccal mucosa. Her neck was stiff and Kernig’s
signs was positive. There were no focal neurological signs and examination of
her cardiovascular and respiratory systems and abdomen was unremarkable.
CT scanning of her head did not show any abnormality
Lumbar puncture was performed and the following results
CSF opening pressure 220 mm of water
Cells 120 per mm3 (lymphocytes)
Glucose 1.3mmol/L (blood glucose 5.4 mmol/L)
Gram stain negative
Ziehl Nielsen stain negative
In this patient which one of the following tests would
enable you to rapidly reach a diagnosis?
PCR for tuberculosis
Viral antibody titres
CSF protein electrophoresis
India ink stain