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Tumor tuberculosis is caused by Mycobacterium tuberculosis Non-suppurative inflammation of the meninges. Often secondary to miliary tuberculosis or other organ tuberculosis. It is more common in children in the past, often the result of blood source dissemination of the primary pulmonary syndrome, or part of the whole body millet tuberculosis. The adult incidence rate accounts for more than half, and the incidence rate of young people is higher, but it can also be seen in old age. (1) Key points
Medical history: Most patients have a history of newly infected tuberculosis or a history of close contact with tuberculosis or tuberculosis.
Symptoms: There are often 10 to 20 days of prodromal symptoms, such as mental stimulation, general weakness, loss of appetite, emotional upset, irritability, low fever, nausea, vomiting, Constipation and so on. Gradually, drowsiness, increased headache, and increased intracranial pressure such as jet vomiting, neck stiffness, and meningitis irritation. Unconscious, gradually entering a coma. At this point all the reflections disappeared, incontinence, pupil positioning, pulse rate increase, irregular breathing, and ultimately death.
signs: body temperature is more than 38 °C, and the body temperature of miliary tuberculosis can reach 40 °C. Multi-directional lying on the side (shame), skin scratching reaction is mostly allergic. The child was raised in front of the room. In the early stage, the pupil was shrunk due to photophobia, and the early stage was enlarged and fixed, and the response to light was slow or even disappeared. There may be optic nerve palsy, drooping eyelids, and diplopia. In most patients, the neck is stiff, pathological nerve reflex is positive, and physiological nerve reflexes are weakened or disappeared.
(1) Cerebrospinal fluid examination: The pressure is increased, the appearance is colorless transparent or frosted glass, and it can also be pale yellow. Film formation can be achieved by standing for 24 hours. Cell number and protein increase, sugar and chloride decrease. Tuberculosis culture can be positive, anti-tuberculosis antibodies are elevated, and immunoglobulin is elevated.
(2) Fundus examination: There may be nodules on the retina. It can be determined that there is intracranial hypertension in papilledema.
(3) Tuberculin test: Positive has a reference value for diagnosis, but negative can not rule out tuberculous meningitis.
(4) X-ray examination: X-ray examination of the lungs, such as the primary syndrome, active tuberculosis, especially miliary tuberculosis, contribute to the diagnosis of tuberculous meningitis.
(5) CT examination: it can show miliary lesions in the meninges and brain parenchyma, tuberculoma and caseous lesions, as well as exudates at the bottom of the brain, edema of brain tissue, and dilatation of the ventricles. It is of great significance for the classification, judgment and treatment of tuberculous meningitis.
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