化脓性脑膜炎误诊为结核性脑膜炎3例

Report of 3 Cases of Purulent Meningitis Misdiagnosed as Tuberculous Meningitis

总结三例化脓性脑膜炎误诊为结核性脑膜炎。其原因:未认真研究病史与基层医院的治疗效果与进程;出现神经系统症状后未追踪检查观察是否有占位病变;过分依赖脑脊液理化检查,缺乏动态分析,且忽视细菌学检查。提示应争取在用抗菌素前作脑脊液常规与细菌学检查;分析脑脊液检查时应结合临床动态。

Three cases of purulent meningitis misdiagnised as tuberculous meningitis are reported. The causes of misdiagnosis were that the history of the illnese had not been thoroughly taken, the treatments given in the elementary clinics and their results had not been fully asked, the mass within the skull had not been mentioned even after abnormal signs of nervous system had been present, the physical and chemical data of CSF, had been over emphasized without careful analysis, the bacterio- logical examination of CSF was neglected by the physicians. It is suggested that a bacteria culture of CSF should be done before the administration of any antibiotics. A correct diagnosis could be done according to the CSF data and clinical manifestations.