Interpretation of Social Organization Standard of Diagnosis of central nervous system tuberculosis in children

doi:10.19982/j.issn.1000-6621.20220425

Abstract

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R529.9
C65

Wang Zeming, Shen Adong. Interpretation of Social Organization Standard of Diagnosis of central nervous system tuberculosis in children[J]. Chinese Journal of Antituberculosis, 2023, 45(1): 18-24. doi: 10.19982/j.issn.1000-6621.20220425

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References 38

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诊断评分项目	评分(分)
接触史及临床表现	最高计6分
症状持续时间≥5d	4
包含1种或多种结核中毒症状(如体质量减轻、盗汗等);或持续咳嗽≥2周	2
1年内与传染性结核病患者密切接触,或结核菌素皮肤试验/γ-干扰素释放试验阳性者(仅限于<10岁儿童)	2
局灶性神经功能缺损(不包括脑神经麻痹)	1
脑神经麻痹	1
意识状态改变	1
脑脊液检查	最高计4分
外观透明	1
细胞数为(10~500)×10⁶/L	1
淋巴细胞占比>50%	1
蛋白质>1g/L	1
葡萄糖<2.2mmol/L或低于血糖的50%	1
头颅影像学检查	最高计6分
结核瘤	2
基底脑池的脑膜强化	2
平扫时颅底脑池变窄,密度增高	2
脑积水	1
脑梗死	1
其他部位结核病证据	最高计4分
胸部影像学提示活动性肺结核(肺结核2分,粟粒型肺结核4分)	2/4
CT、MRI、超声检查提示存在颅外其他系统结核	2
脑脊液以外的标本(痰液、淋巴结、胃液、尿液、血液等)抗酸染色或MTB培养阳性	4
脑脊液以外的标本(痰液、淋巴结、胃液、尿液、血液等)MTB分子生物学检测阳性	4
排除诊断通过病原学(涂片抗酸染色、培养或分子生物学检测)、免疫学或病理学检查,除外其他疾病,如化脓性脑膜炎、病毒性脑膜脑炎、隐球菌性脑膜炎、梅毒性脑膜炎、脑型疟疾、寄生虫性脑膜炎、嗜酸性粒细胞增多性脑膜炎、弓形体脑病、颅内占位性病变(如脑脓肿、恶性肿瘤等)

Interpretation of Social Organization Standard of Diagnosis of central nervous system tuberculosis in children

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