WANG Tao 1,2 , ZHOU Liang 1 , YANG Hongxia 1 , TANG Shufu 1 , LI Nana 1 , CHEN Xuerong 2 , ZHANG Jianyong 1
  • 1. Second Department of Respiratory, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P. R. China;
  • 2. Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
CHEN Xuerong, Email: 384481688@qq.com; ZHANG Jianyong, Email: 183307838@qq.com
Tuberculous meningitis; Clinical diagnosis; Antituberculosis treatment
10.7507/1002-0179.201807132
Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables References Cited by

Objective  To comprehensively observe, recognize, learn and understand the clinical features of tuberculous meningitis (TBM). Methods  We retrospectively analyzed the general data, clinical manifestations, clinical examinations and treatment prognosis of 152 patients with TBM who were hospitalized in the Second Affiliated Hospital of Zunyi Medical College between January 2016 and February 2017. Results  The mean age of the 152 patients with TBM was (43.9±20.4) years old, the ratio of male to female was 1.45:1, and the average length of hospital stay was (20.0±18.9) days. The clinical manifestations were mainly headache [95.4% (145/152)], nausea and vomiting [42.8% (65/152)], and fever [61.8% (94/152)]. The main co-morbidities were secondary pulmonary tuberculosis [52.0% (79/152)], hematogenous disseminated tuberculosis [37.5% (57/152)], and tuberculous pleurisy [30.9% (47/152)]. The positive rate of γ-interferon release test was 90.8% (129/142), and the brain pressure of lumbar puncture was elevated. The typical biochemical changes of cerebrospinal fluid were " low glucose, low chlorine, and high protein”. The positive rate of tuberculosis smear was extremely low, and the positive rate of GeneXpert MTB/RIF in cerebrospinal fluid was 21.9% (7/32). The TBM patiens were prone to combine with hypoproteinemia, the proportion reached 29.6% (45/152), and the proportion of hyponatremia reached 45.3% (69/152). Treated with early diagnosis and treatment, 92.1% (140/152) improved and discharged. Conclusions  TBM patients are mainly young and middle-aged with various clinical manifestations and less respiratory symptoms; and are easy to be combined with pulmonary tuberculosis and other extrapulmonary tuberculosis. γ-interferon release test and cerebrospinal fluid GeneXpert MTB/RIF can be used for the auxiliary diagnosis of tuberculosis. Early detection, early diagnosis and treatment, rational and regular chemotherapy, strengthening symptomatic supportive treatment, and improving the precise diagnosis and treatment of TBM, can improve its clinical prognosis.

Citation： WANG Tao, ZHOU Liang, YANG Hongxia, TANG Shufu, LI Nana, CHEN Xuerong, ZHANG Jianyong. Immunological and molecular technology assisting diagnosis: clinical characteristics analysis of 152 cases of tuberculous meningitis in northern Guizhou. West China Medical Journal, 2018, 33(8): 972-976. doi: 10.7507/1002-0179.201807132 Copy

  • Previous Article

    Diagnositic efficacy of clinical characteristics and laboratory indexes in tuberculous pleural effusion and malignant pleural effusion

  • Next Article

    Diagnostic value of serum proteomic assay for pulmonary tuberculosis: evidence from a Meta-analysis