结核性脑膜炎——100例患者的临床和实验室回顾。

M E Kilpatrick, N I Girgis, M W Yassin, A A Abu el Ella
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引用次数: 45

摘要

在发展中国家,结核性脑膜炎是一种难以与其他中枢神经系统感染区分的感染。本文介绍了100例脑脊液培养呈结核分枝杆菌阳性的特殊病房患者的病史、体格检查、实验室资料和临床过程。54例患者入院时处于昏迷状态,76例有脑膜征。平均入院脑脊液值为WBC 531,葡萄糖23 mg/dl,蛋白质166 mg/dl。仅有2例脑脊液AFB涂片阳性。61%的胸部x光片符合肺结核,39%正常。24例患者在入院后1周内死亡,当时尚未作出临床诊断并开始抗结核治疗。76名接受抗结核治疗的患者中有53人死亡。48%的幸存者有神经系统后遗症。该患者组的高死亡率和高发病率是由于入院时疾病的严重程度和以儿童为主(54%)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tuberculous meningitis--clinical and laboratory review of 100 patients.

In developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).

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