Amacher A, Rutishauser M
Universitäts-Kinderklinik, Basel.
Pneumologie. 1990 Oct;44(10):1211-2.
Three cases of tuberculosis infection are presented (spondylitis, meningitis, pericarditis). Pitfalls and blunders delaying tuberculosis diagnosis are reported. The authors emphasize that: Children at risk have to be vaccinated with BCG (1.1). Health professionals must repeatedly be taught in the interpretation of tuberculin test results and chest X-rays. Tuberculous meningitis may be hidden by the presentation of only encephalitis symptoms and liquor analysis reveals an atypical result (3). Spontaneous resolution of the symptoms or an improvement under non-tuberculostatic therapy does not exclude tuberculosis. In fact encephalitic signs may improve or disappear spontaneously despite subsequent positive liquor culture (4).
本文介绍了三例结核感染病例(脊柱炎、脑膜炎、心包炎)。报告了延误结核病诊断的陷阱和失误。作者强调:高危儿童必须接种卡介苗(1.1)。必须反复对卫生专业人员进行结核菌素试验结果解读和胸部X光检查方面的培训。结核性脑膜炎可能仅表现为脑炎症状而被掩盖,脑脊液分析显示非典型结果(3)。症状的自发缓解或在非抗结核治疗下的改善并不排除结核病。事实上,尽管随后脑脊液培养呈阳性,但脑炎体征可能会自发改善或消失(4)。