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脑囊虫在北方是一种常见病,但由于医务人员对本病缺乏应有的警惕性,对不典型的病例往往误诊误治,其中囊虫性脑膜炎(cysticercus mening-itis)常被误诊为结核性或隐球菌性、病毒性脑膜炎等。病例报告男,29岁,河北定兴人,于1984年1月26日入院。主诉:间断发热、头痛、呕吐4个月。患者于4月前在受冻后发热,体温38~39℃浑身酸痛,头痛,无固定位置,厉害时伴呕吐。当时曾作腰穿,压力230mmH_2O,脑脊液白细胞20/mm~3,蛋白64mg%,糖50mg%,氯化物730mg%,脑脊液抗酸杆菌及隐球菌均阴性。无抽搐。既往无明确的吃“豆猪肉”史,大便未解过绦虫。检查:无皮下结节,体温37℃,心,肺无异常,肝、脾未触及。双视乳头边缘不清,无出血或渗出,右眼外展欠充分,其他颅神经未见异常,四肢肌力,肌张力如常,睫反射适中、对称,无病理反射,腹壁及提睾反射灵活,颈部不强直,Kernig征阴性。在院
Cerebral cysticercosis is a common disease in the north, but due to the lack of vigilance of medical personnel on the disease, misdiagnosis and mistreatment are often used in atypical cases. Cysticercosis meningitis (cysticercus meningitis) is often misdiagnosed as tuberculosis Sexual or cryptococcal, viral meningitis. Case report Male, 29 years old, Hebei Dingxing people, admitted to hospital on January 26, 1984. Chief complaint: intermittent fever, headache, vomiting 4 months. Patients in the cold before April after fever, body temperature 38 ~ 39 ° whole body ache, headache, no fixed position, powerful with vomiting. At that time, we used to wear lumbar puncture, pressure 230mmH2O, cerebrospinal fluid leukocyte 20 / mm ~ 3, protein 64mg%, sugar 50mg%, chloride 730mg%, cerebrospinal fluid acid-fast bacilli and Cryptococcus were negative. No convulsions. Past no clear eating “beans pork” history, the stool did not know tapeworm. Check: no subcutaneous nodules, body temperature 37 ℃, heart, lung no abnormalities, liver, spleen not touched. Bilateral nipple edge is unclear, no bleeding or exudation, right eye outreach less than adequate, the other cranial nerves were normal, muscle strength, muscle tone as usual, moderate ciliary reflex, symmetry, no pathological reflexes, abdomen and cremaster reflex Flexible, neck is not straight, Kernig sign negative. In the hospital