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Less 等(1980)报道2例结核性脑膜炎在积极治疗期间发生脑结核瘤。作者近来亦见到一类似病例。患者男性,33岁,因发热,头痛10天而住院。神经系统检查:颈强直,无视乳头水肿,余无特殊发现。脑脊液:淋巴细胞156/mm~3,蛋白质100mg%,糖35.2mg%。结核杆菌涂片阴性、培养阳性,对所有抗结核药均敏感。胸部透视正常。结核菌素皮试强阳性。每日口服异烟肼5mg/kg,利福平10mg/kg 和乙胺丁醇20mg/kg 治疗。2周后患者仍有发热和轻度定向障碍,视乳头轻度水肿。脑 CT 扫描显示有广泛
Less et al. (1980) reported 2 cases of tuberculous meningitis with brain tuberculoma during aggressive treatment. The author also recently saw a similar case. Male patient, 33 years old, hospitalized for fever and headache for 10 days. Nervous system examination: neck stiffness, ignoring papillary edema, I found no special. Cerebrospinal fluid: lymphocytes 156 / mm ~ 3, protein 100mg%, sugar 35.2mg%. Mycobacterium tuberculosis smear negative, positive culture, all anti-TB drugs are sensitive. Chest perspective normal. Tuberculin skin test strongly positive. Daily oral isoniazid 5mg / kg, rifampicin 10mg / kg and ethambutol 20mg / kg treatment. Two weeks later, the patient still had fever and mild disorientation, with slight edema of the optic nerve. Brain CT scan showed a wide range