Tinsa Faten, Essaddam Leila, Fitouri Zohra, Boussetta Khadija, Ben Becher Saida, Bousnina Souad
Department of Pediatrics B, Children's Hospital of Tunis, Tunis, Tunisia.
J Child Neurol. 2010 Jan;25(1):102-6. doi: 10.1177/0883073809336129.
The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. In this report, we reviewed the clinical features and laboratory findings of 6 infants with central system nervous tuberculosis during a 10-year period. One of the patients had multifocal tuberculosis. The mean time to the diagnosis was 32 +/- 13.4 days. A contact source was identified in only 2 patients. All 6 patients had abnormal cerebrospinal fluid findings, less than 500 cells/microL with lymphocytic predominance. Computerized tomography (CT) and/or magnetic resonance imaging (MRI) revealed hydrocephalus with basal enhancement in 2 patients. One patient developed pontocerebellar and pituitary tuberculomas, which were responsible for compression and diabetes insipidus, 1 year after antituberculous treatment. These localizations are very rare. On the follow-up, 3 patients had hypoacousia and only 1 had severe sequelae, despite a diagnostic delay.
结核性脑膜炎患者缺乏特异性症状和体征，导致早期诊断困难。在本报告中，我们回顾了10年间6例中枢神经系统结核婴儿的临床特征和实验室检查结果。其中1例患者有多灶性结核。诊断的平均时间为32±13.4天。仅2例患者确定了接触源。所有6例患者脑脊液检查均异常，细胞数少于500个/微升，以淋巴细胞为主。计算机断层扫描（CT）和/或磁共振成像（MRI）显示2例患者有脑积水伴基底节强化。1例患者在抗结核治疗1年后出现桥小脑和垂体结核瘤，导致压迫和尿崩症。这些定位非常罕见。随访时，3例患者有听力减退，尽管诊断延迟，但只有1例有严重后遗症。
