Kilpatrick M E, Girgis N I, Yassin M W, Abu el Ella A A
J Hyg (Lond). 1986 Apr;96(2):231-8. doi: 10.1017/s0022172400066006.
In developing countries tuberculous meningitis is a difficult infection to differentiate from other central nervous system (CNS) infections. This paper presents the history, physical findings, laboratory data, and clinical course of 100 patients who were admitted to a special ward and had CSF cultures positive for Mycobacterium tuberculosis. Fifty-four patients were comatose when admitted and 76 had meningeal signs. Mean admission CSF values were WBC 531, glucose 23 mg/dl, and protein 166 mg/dl. Only two CSF AFB smears were positive. Sixty-one percent of the chest X-rays taken were consistent with pulmonary tuberculous and 39% were normal. Twenty-four patients died within the first week after admission, before the clinical diagnosis was made and anti-tuberculous therapy could be started. Fifty-three of 76 patients given antituberculous therapy died. Neurologic sequelae developed in 48% of the survivors. The high mortality and morbidity rates in this patient-group were due to the severity of illness on admission and the predominance of children (54%).
在发展中国家，结核性脑膜炎是一种难以与其他中枢神经系统（CNS）感染相鉴别的感染性疾病。本文介绍了100例入住特殊病房且脑脊液培养结核分枝杆菌呈阳性患者的病史、体格检查结果、实验室数据及临床病程。54例患者入院时昏迷，76例有脑膜刺激征。入院时脑脊液平均数值为白细胞531、葡萄糖23mg/dl、蛋白质166mg/dl。仅两份脑脊液抗酸杆菌涂片呈阳性。61%的胸部X线检查结果符合肺结核表现，39%正常。24例患者在入院后第一周内死亡，此时尚未作出临床诊断且未开始抗结核治疗。接受抗结核治疗的76例患者中有53例死亡。48%的幸存者出现神经系统后遗症。该患者群体的高死亡率和高发病率是由于入院时病情严重以及儿童占多数（54%）。
