[An analysis of the early diagnostic criteria for tuberculosis meningitis].

OBJECTIVE

To find a method for the early diagnosis of tuberculous meningitis (TM).

METHODS

Cases with the discharge diagnosis of TM during 1995 - 2004 ten years in the Peking Union Medical College Hospital were analyzed retrospectively. History of tuberculosis other sites of tuberculous infection, the findings of cerebrospinal fluid (CSF) and CSF culture result were studied.

RESULTS

16 of the 68 patients had past history of tuberculosis. During hospitalization 20 had pulmonary tuberculosis, while 9 had other sites of tuberculous infection. The rate of tuberculous infection aside from neurological system was 43%. The top 7 clinical manifestations were: coma, onset of the disease more than 5 days, lymphocyte predominant in CSF, glucose level in CSF 50% lower than that of blood, abnormal CT findings. Abnormal ocular fundi and proved tuberculosis of other sites.

CONCLUSIONS

TM is often accompanied with tuberculous infection of other sites. Its diagnosis can not be relied mainly on the culture result of CSf. When 4 of the 7 above mentioned criteria are present, TM should be diagnosed and anti-tuberculosis therapy started.