Herta K-D, Sturzenegger M, Berkhoff M
Psychiatrische Poliklinik, Universitätsspital Zürich, Zürich.
Nervenarzt. 2005 Jan;76(1):68-71. doi: 10.1007/s00115-004-1702-y.
Little is known about the type and frequency of psycho-organic syndromes among prisoners. We report the case of a 20-year-old African HIV-I-positive male asylum seeker who developed increasingly bizarre behaviour in prison. The observation of complex behavioural disturbances with a hallucinatory-delusional state led to the diagnosis of delirium caused by AIDS-defining tuberculous meningoencephalitis. The patient improved with specific, symptomatic treatment. This case illustrates the difficulties in diagnosis when communication is impeded. Scrupulous differential diagnosis is necessary for all prisoners manifesting behavioural disturbances. We discuss the pathogenesis and diagnostic procedures of tuberculous meningoencephalitis.
关于囚犯中精神器质性综合征的类型和发生率，人们知之甚少。我们报告一例20岁的非洲男性寻求庇护者，他感染了HIV-I且呈阳性，在狱中出现了日益怪异的行为。对伴有幻觉-妄想状态的复杂行为障碍的观察，导致诊断为由艾滋病界定的结核性脑膜脑炎所致的谵妄。患者经特异性对症治疗后病情好转。该病例说明了在沟通受阻时诊断的困难。对于所有表现出行为障碍的囚犯，必须进行细致的鉴别诊断。我们讨论了结核性脑膜脑炎的发病机制和诊断程序。
