Youssef Fouad G, Afifi Salma A, Azab Adel M, Wasfy Momtaz M, Abdel-Aziz Khalid M, Parker Tina M, Oun Saeid A, Jobanputra Nishith N, Hajjeh Rana A
Disease Surveillance Program, U.S. Naval Medical Research Unit No.3, Cairo, Egypt.
Diagn Microbiol Infect Dis. 2006 Aug;55(4):275-8. doi: 10.1016/j.diagmicrobio.2006.01.027. Epub 2006 Apr 19.
Tuberculous meningitis (TBM) is still a major cause of serious illness in many parts of the world. The newer diagnostic tests and neuroimaging methods are unlikely to be available in many developing countries. We attempt to identify simple parameters for early diagnosis. A retrospective study was performed to compare the clinical and laboratory features of cultured-confirmed, TBM (134) and other bacterial meningitis (709). Features independently predictive of TBM were studied by multivariate logistic regression to develop a diagnostic rule. Six features were found predictive: length of clinical history >5 days, headache, total cerebrospinal fluid (CSF) white blood cell count of <1000/mm3, clear appearance of CSF, lymphocyte proportion of >30%, and protein content of >100 mg/dL. Application of 3 or more parameters revealed 93% sensitivity and 77% specificity. Applying this diagnostic rule can help in the early diagnosis of TBM, in both children and adults.
结核性脑膜炎（TBM）在世界许多地区仍是严重疾病的主要病因。许多发展中国家不太可能采用更新的诊断测试和神经影像学方法。我们试图确定早期诊断的简单参数。进行了一项回顾性研究，比较培养确诊的结核性脑膜炎患者（134例）和其他细菌性脑膜炎患者（709例）的临床和实验室特征。通过多因素逻辑回归研究独立预测结核性脑膜炎的特征，以制定诊断规则。发现有六个特征具有预测性：临床病史时长>5天、头痛、脑脊液（CSF）白细胞总数<1000/mm³、脑脊液外观清亮、淋巴细胞比例>30%以及蛋白含量>100mg/dL。应用3个或更多参数显示敏感性为93%，特异性为77%。应用此诊断规则有助于儿童和成人结核性脑膜炎的早期诊断。
