关键词: 结核,脑膜, 诊断, 治疗

Abstract: Objective To study the clinical diagnosis and treatment of untypical tuberculosis meningitis(TBM). Method To analysis the clinical characteristics and the diagnosis basis on the 68 untypical TBM casesrespectively.3HS(E)RZ/9HRZ treatment regimen were adapted,DXM were used as well as to lower the head pressure. Results Sixty-eight cases were divided into two categories.Among them,67 cases are alive,one died,and no sequel left.Furthermore,64 cases have been followed up for over 2 years. Conclusions Diagnosis of untypical TBM can be based on the basis of following manifestations:(1)Manifestations of active pulmonary tuberculosis.(2)Changes of untypical cerebrospinal fluid(CSF) or/and manifestations of untypical TBM.(3)The experiment antituberculotic therapy is effect.(4)Non-TBM diseases can be excepted.(5)PPD antibody in CSF is positive,ADA in CSF is high.(6)Images of head CT and MRI accord with TB changes.(7)Tuberculotical mycobacterium can be found in CSF.If there are 3 items in the anterior 6 or possesses the 7th items alone,the untypical TBM can be determined,and to adapt HS(E)RZ that four drugs are union as a twelve month chemical therapy will be safe and effective.

Key words: Tuberculosis,Meninx, Diagnosis, Treatment