Given the high prevalence of cryptococcus and the similar initial presentations between cryptococcal meningitis and tuberculous meningitis, fingerstick cryptococcal antigen lateral flow assay (LFA; Immy, Norman, OK, USA) was done at the participant's bedside. Thereafter, lumbar puncture was done for all participants, CSF opening pressure was recorded, and CSF was collected into a sterile tube with a target volume of more than 6 mL. At the bedside, CSF glucose and lactate were measured from a drop of CSF collected into an Eppendorf tube using a handheld OneTouch glucose meter (OneTouch; Lifescan, Inverness, UK) and a point-of-care lactate meter (Nova Biomedical; Waltham, MA, USA). Xpert and Xpert Ultra results were returned to the study team within 24 h to guide treatment decisions.
Clinical history, physical examination, and detailed neurological assessment findings were recorded as recommended by the Tuberculous Meningitis International Research Consortium.22 (link) Other diagnostic tests, including urine tuberculosis lipoarabinomannan (Alere Determine; Alere, Waltham, MA, USA), chest radiograph, abdominal ultrasonography, brain imaging, and sputum Xpert, were done as clinically indicated and when locally available.
Clinical history, physical examination, and detailed neurological assessment findings were recorded as recommended by the Tuberculous Meningitis International Research Consortium.22 (link) Other diagnostic tests, including urine tuberculosis lipoarabinomannan (Alere Determine; Alere, Waltham, MA, USA), chest radiograph, abdominal ultrasonography, brain imaging, and sputum Xpert, were done as clinically indicated and when locally available.