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病人女 37岁农民住院号10189。因头痛、呕吐、抽搐、谵语,于1983年3月11日入院。既往有肺结核和结核性腹膜炎史。查体:嗜睡、颈轻度抵抗、四肢活动自如,肌力、肌张力正常;左侧Oppenheim氏征阳性、右侧踝阵挛阳性。化验:血沉31mm,脑脊液细胞数310,白血球151,多核17％,单核83％;潘氏++++;蛋白3860mg/dL、糖10～20mg/dL、氯化物584.4mg/dL。诊断为结核性脑膜炎。经用RFP、SM、INH和糖皮质激素治疗1周,呕吐、抽搐和谵语症状消失,头痛明显好转。入院第40天,复查脑脊液:淡黄色,细胞数62,白血球21;潘氏++++。第64天,经治进修医师在第3～4腰椎间隙穿刺,留取脑脊液标本后,将硫酸链霉素0.5、INH0.1和氟美松5mg的混合液注入椎管内。约1小时患者两下肢麻木、不能活动。查体:耻骨联
Female 37-year-old patient hospitalization No. 10189. He was admitted to hospital on March 11, 1983 because of headaches, vomiting, convulsions and obscenities. Past history of tuberculosis and tuberculous peritonitis. Physical examination: lethargy, neck mild resistance, limbs freely, muscle strength, muscle tone normal; positive Oppenheim’s sign on the left, positive right ankle clonus. Assay: erythrocyte sedimentation rate 31mm, cerebrospinal fluid cell number 310, leukocyte 151, multinucleated 17%, mononuclear 83%; Pan’s ++++; protein 3860mg / dL, sugar 10-20mg / dL, chloride 584.4mg / dL. Diagnosis of tuberculous meningitis. After a week of treatment with RFP, SM, INH and glucocorticoids, symptoms of vomiting, convulsions and vomit disappeared and headache was significantly improved. Forty days after admission, cerebrospinal fluid was reviewed: pale yellow, 62 cells, white blood cells 21; Pan’s ++++. On the 64th day, the attending physician punctured the lumbar intervertebral space 3 ~ 4 and collected the cerebrospinal fluid samples. The mixture of streptomycin sulfate, INH0.1 and 5 mg of dexamethasone was injected into the spinal canal. About 1 hour two numb patients, can not move. Physical examination: pubic symphysis