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1961～1985年25年中,我们接诊了外院诊为各种传染病而转来的结核性脑膜炎90例,误诊原因分析如下。其中误诊为流行性乙型脑炎42例占46.6％,流行性脑膜炎或化脓性脑膜炎30例占33.3％,伤寒12例占13.4％,脊髓灰质炎4例占4.5％,脑膜脑炎型钩端螺旋体病2例占2.2％。一、误诊原因 1.42例误诊为流行性乙型脑炎的原因: (1)28例患者均在流行性乙型脑炎的好发年龄10岁以下,25例发病在每年的6月下旬至7月的流行性乙型脑炎发病高峰期。 (2)15例有与流行性乙型脑炎相似的起病经过,如持续高热与嗜睡。 (3)脑脊髓液呈类似病毒性中枢神经感染改变。如25例脑脊髓液的葡萄糖量不减;12例氯化物不减少;12例蛋白量不增多;10例白细
During the 25 years from 1961 to 1985, 90 cases of tuberculous meningitis were referred to the outpatient department for various infectious diseases. The causes of misdiagnosis are as follows. 42 cases were misdiagnosed as JE in 46 cases, 33 cases were epidemic meningitis or purulent meningitis in 30 cases, 12 cases in typhoid fever accounted for 13.4%, 4 cases in poliomyelitis accounted for 4.5%, meningoencephalitis Leptospirosis in 2 cases accounted for 2.2%. First, the causes of misdiagnosis 1.42 cases of misdiagnosed as Japanese encephalitis reasons: (1) 28 patients were in the age of onset of Japanese encephalitis under the age of 10, 25 cases of onset in the end of June every year to 7 Month of the peak incidence of Japanese encephalitis. (2) 15 cases had similar onset of Japanese encephalitis, such as persistent fever and lethargy. (3) cerebrospinal fluid was similar to the change of viral central nervous system infection. Such as 25 cases of cerebrospinal fluid glucose did not diminish; 12 cases of chloride did not reduce; 12 cases of protein does not increase; 10 white