Cresswell FV, et al. - In 1%–5% of tuberculosis cases, tuberculous meningitis occurs, researchers evaluated the new Xpert MTB/RIF Ultra (Xpert Ultra) concerning its performance for diagnosing tuberculous meningitis. They conducted a prospective validation study examining the cerebrospinal fluid (CSF) of adults presenting with suspected meningitis (ie, headache or altered mental status with clinical signs of meningism) to the Mulago National Referral Hospital and Mbarara Regional Referral Hospital in Uganda. Following centrifugation of the CSF, the cell pellet was resuspended in 2 mL CSF, and 0·5 mL aliquots were tested with Xpert Ultra, Xpert MTB/RIF (Xpert), and mycobacterial growth indicator tube (MGIT) culture. Four hundred sixty-six adults with suspected meningitis were screened and 204 were tested for tuberculous meningitis from Nov 25, 2016, to Jan 24, 2019. The outcomes revealed a higher sensitivity of Xpert Ultra in the detection of tuberculous meningitis than Xpert and MGIT culture in this HIV-positive population. However, there seemed no possible utility of Xpert Ultra as a rule-out test given its negative predictive value of 93%. Findings still suggest the necessity for clinical judgment and novel highly sensitive point-of-care tests.