小儿结核性脑膜炎早期诊断及误诊分析

对我院收治的72例小儿结核性脑膜炎(TBM)中的48例误诊病例进行回顾性分析,认为对TBM缺乏警觉性,流行病学资料不完整,TBM早期临床表现及CSF改变不典型是误诊的主要原因.对疑似病例应及时行PPD试验,CSF常规检查及头颅CT或MRI检查,必要时行PCR-TB-DNA检测,有助于TBM的早期诊断.这是目前基层医院TBM早期诊断的主要手段.

An Analysis of the Early Diagnosis and Misdiagnosis of Children Tuberculous Meningitis

We retrospective analyze of 48 cases of 72 pediatric patients with pdeo-cerebral tuberculosis in our department.We have found that the main misdiagnosis reasons are probably contained in the lack of watchfulness of TBM,uncompleted epidemiology information,and un-typical clinical manifestations and CSF changes.We suggest that uncertain and precarious cases should be treated by using PPD detection,cerebrospinal fluid(CSF) common test,cerebral CT or MRI scan,when it is needed,PCR-TB-DNA test will be used in order to right diagnosis them at the early time.These methods mentioned above are very common useful use for diagnosis TBM at the early time in basic level hospital.