Sonneveld Myrthe Elisabeth, Zinkstok S M, Nellen F J B, Holleboom Adriaan G
Department of Internal Medicine, University of Amsterdam, Academic Medical Centre, Amsterdam, The Netherlands.
BMJ Case Rep. 2012 Aug 18;2012:bcr2012006627. doi: 10.1136/bcr-2012-006627.
A 58-year-old man from Surinam was referred because of nausea, vomiting, weight loss, ascites and an altered mental state. Tuberculous meningitis was suspected upon examination of the cerebrospinal fluid and antituberculous treatment was initiated. However, the patient did not recover but developed haemiplegia with recurrent aspiration pneumonias. This case illustrates that empiric antituberculous treatment is warranted upon clinical suspicion, since no fast, sensitive diagnostic tests are available to date.
一名来自苏里南的58岁男子因恶心、呕吐、体重减轻、腹水和精神状态改变而前来就诊。脑脊液检查怀疑为结核性脑膜炎，并开始进行抗结核治疗。然而，患者并未康复，反而出现偏瘫并反复发生吸入性肺炎。该病例表明，由于目前尚无快速、灵敏的诊断测试，因此在临床怀疑时进行经验性抗结核治疗是必要的。
