RESUMEN
Clinical patterns of tuberculous meningitis have been analyzed for 32 admissions to the bacterial meningitis department of the 2nd Moscow Infection Hospital in 1983-1991. Early diagnosis of tuberculous meningitis caused great difficulties because of rare cases of tuberculous history, atypical symptoms (an acute onset, in particular), an obscure meningeal syndrome, rare neurological symptoms, atypical liquor characteristics (frequent neutrophil pleocytosis, a small protein rise, normal glucose). Secondary bacterial meningitides presented most serious difficulties for differential diagnosis. So did cerebral abscesses and viral meningitis. Antituberculous therapy should be started at first sings of tuberculous nature of meningitis as the disease outcomes are determined to a large extent by early administration of proper treatment.
Asunto(s)
Tuberculosis Meníngea/diagnóstico , Adolescente , Adulto , Diagnóstico Diferencial , Errores Diagnósticos , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Tuberculosis Meníngea/líquido cefalorraquídeoAsunto(s)
Barrera Hematoencefálica/fisiología , Meningitis Meningocócica/metabolismo , Meningitis Neumocócica/metabolismo , Proteínas del Tejido Nervioso/análisis , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , alfa-Globulinas/análisis , Antígenos/análisis , Encéfalo/inmunología , Epítopos/análisis , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Altogether 20 patients with purulent meningitis caused by agents of rare species were observed. Difficulties in etiological diagnosis and the severity of a clinical course were noted. In most cases this disease developed in persons with associated diseases. In a lingering course of the disease repeated bacteriological investigations of blood and liquor, and serological investigations are recommended.