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[结核性脑膜脑炎——自身观察]

[Tuberculous meningoencephalitis--own observations].

作者信息

Garlicki Aleksander, Kluba-Wojewoda Urszula, Bociaga-Jasik Monika, Kalinowska-Nowak Anna, Sobczyk-Krupiarz Iwona, Mach Tomasz

机构信息

Katedra i Klinika Chorób Zakaźnych Collegium Medicum Uniwersytetu Jagiellońskiego ul. Sniadeckich 5, 31-531 Kraków.

出版信息

Folia Med Cracov. 2003;44(1-2):27-38.

Abstract

Nine cases of the tuberculous meningoencephalitis in adult men and women treated in years 1993-2000 have been presented. The diagnosis was established on the basis of clinical picture and examination of the cerebrospinal fluid (CSF). Routine analysis of CSF was done, as well as the microscopic examination, biological assay, and culture on the Lowenstein-Jensena medium and using Bactec 460 TB system. Only in one case Mycobacterium tuberculosis was found in the smear of CSF stained by Ziehl-Nielsen method. In one case the biologic assay was positive and Mycobacterium tuberculosis was cultured on Lowenstein-Jensen medium. In another 4 cases the pathogen was detected by Bactec 460 TB technique. In 4 cases Mycobacterium tuberculosis was also cultured from the secretion of the respiratory tract, and in one patient urine. On chest X-ray characteristic changes for pulmonary tuberculosis were observed in 5 cases (56%). Seven patients (78%) had hydrocephalus detected on CT scan of the head. One patient died, one (11%) developed persistent complication in form of spastic paralysis of lower extremities and sphincters dysfunction. Seven patients (78%) recovered completely after the 12 months therapy with standard chemotherapeutic regimen for tuberculosis.

摘要

本文报告了1993年至2000年间收治的9例成年男女结核性脑膜脑炎病例。诊断依据临床表现及脑脊液(CSF)检查确定。对CSF进行了常规分析、显微镜检查、生物学检测,并在罗-琴培养基上培养,同时使用Bactec 460 TB系统。仅1例经萋-尼氏法染色的CSF涂片发现结核分枝杆菌。1例生物学检测呈阳性,结核分枝杆菌在罗-琴培养基上培养成功。另外4例通过Bactec 460 TB技术检测到病原体。4例患者呼吸道分泌物中也培养出结核分枝杆菌,1例患者尿液中培养出结核分枝杆菌。胸部X线检查发现5例(56%)有肺结核特征性改变。7例(78%)患者头部CT扫描发现脑积水。1例患者死亡,1例(11%)出现下肢痉挛性瘫痪和括约肌功能障碍的持续性并发症。7例(78%)患者经12个月的标准抗结核化疗方案治疗后完全康复。

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