我院近年来遇到34例结核性脑膜炎在院内外误诊误治。误诊疾病有流行性脑膜炎、脑血管疾病、肺部炎症、偏瘫等。 误诊原因分析:①结脑的临床表现无特异性,故对可疑病人应该严密临床观察,仔细询问与结核病人接触史,并做结核菌素试验,查结核抗体及血沉等。②细菌学检查:此项检查不易获阳性结果,脑脊液涂片检出结核菌的阳性率仅占15％,本组病例无1例阳性。细菌培养需6周以上方能出结果,基层医院又难以开展。③细菌的毒力和患者的免疫状态不同,导致本病临床表现呈现多样化,部分病 In recent years, our hospital encountered 34 cases of tuberculous meningitis misdiagnosis and mistreatment in the hospital. Misdiagnosed diseases are meningitis, cerebrovascular disease, lung inflammation, hemiplegia and so on. Analysis of misdiagnosis: ① tuberculous clinical manifestations of non-specific, it should be closely linked to suspicious clinical observation, careful contact with the history of tuberculosis and tuberculin test, check tuberculosis antibodies and ESR. ② bacteriological examination: This test is not easy to get positive results, the positive rate of CSF smear TB was only 15%, no case of this group of patients were positive. Bacteria need more than 6 weeks to produce results, and grassroots hospitals are hard to carry out. ③ bacterial virulence and immune status of patients is different, leading to the clinical manifestations of the disease showed a diversity, some diseases