关键词: 获得性免疫缺陷综合征;结核, 脑膜/并发症;发热;头痛

Abstract: Objective To summary the clinical data from tuberculous meningitis (TBM) in patients coinfected with acquired immuno-deficiency syndrome (AIDS).  Methods We analyzed retrospectively 32 AIDS cases coinfected with tuberculous meningitis in our hospital from January 1999 to December 2009.  Results There were 30 cases with fever, 29 with headache, 18 with disorder of consciousness, 12 with spasm, 25 with meningismus, 27 with cough, and 25 with productive cough. All the patients had different degrees of AIDS-related presentation and were often coinfected with pulmonary tuberculosis (75%) and extra-pulmonary tuberculosis (12.5%). CD4 count was less than 200/mm³ in all cases. All the patients presented with increased cerebrospinal fluid pressure, WBC, protein and ADA, and with decreased sugar and chloride in the cerebrospinal fluid.  Conclusion s The AIDS patients coinfected with tuberculous meningitis have complex, severe and nonspecified clinical manifestation with high mortality and high disable rates. Antituberculosis plus corticoid and combination treatment with HARRT can decrease mortality, improve life quality and extend life-span.

Key words: AIDS, tuberculous meningeal/complications;fever;headache