结核性脑膜炎(以下简称结脑),临床表现复杂多变,误诊误治的情况常有发生,现报道4例如下:例1,女,3/2岁,于5天前以发热、咳嗽、气喘,在外院诊为肺炎,经抗生素治疗无效。入院前一天发生抽搐、昏迷,以肺炎合并中毒性脑病收入院。其伯母患肺结核,接触密切。未种过卡介苗。体检:T38.5℃,呼吸急促,营养较差,深昏迷,频繁抽搐,两瞳孔不等大,对光反射消失,颈软,双肺闻及痰鸣音,心脏检查无异常,克氏征及布氏征引(一)。白细胞18000/nl,淋巴15%,中性多核80%,中性杆状5%,血沉3mm/lhr,脑脊液白细胞120/nl,淋巴80%,中性20%,葡萄糖>50mg/dl,蛋白125mg/dl,氯化物600mg/dl,一般致病菌培养及结核杆菌培养均(-),0.T1:2000(-),胸片示粟粒性肺结核。入院后经用异烟肼、卡那霉 Tuberculous meningitis (hereinafter referred to as knot brain), the clinical manifestations of complex and changeable, misdiagnosis and mistreatment often occur, are reported in 4 cases as follows: Case 1, female, 3/2 years old, 5 days ago with fever, cough , Asthma, pneumonia in the outpatient clinic, the antibiotic treatment is invalid. The day before admission, convulsions, coma, pneumonia with toxic encephalopathy hospital. His aunt suffering from tuberculosis, close contact. Not seen BCG. Physical examination: T38.5 ℃, shortness of breath, poor nutrition, deep coma, frequent convulsions, ranging from two pupils, light reflex disappeared, soft neck, lung smear and phlegm, cardiac examination was normal, And Briggs cited (a). Leukocyte 18000 / nl, lymphatic 15%, neutral multinucleated 80%, neutral rod 5%, erythrocyte sedimentation rate 3mm / lhr, cerebrospinal fluid leukocyte 120 / nl, lymphatic 80%, neutral 20%, glucose> 50mg / dl, protein 125mg / dl, chloride 600mg / dl, the general pathogenic bacteria culture and Mycobacterium tuberculosis culture (-), 0. T1: 2000 (-), chest showed miliary tuberculosis. After admission by isoniazid, kanamycin