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溴化物分配试验(bromide partition test)为一种结核性脑膜炎特异诊断方法,检出率高,尤其对急性病毒性淋巴细胞脑膜炎的区别有较好的可靠性。但对其临床实用性上则少有评价。本文结合一例误诊报告如下:患者女性,62岁,因厌食,体重减轻四周而入院。住院后又出现激动,精神错乱和头晕。临床检查见患者畏光,视神经乳头水肿;脑电图非特异性异常,CT 扫描正常。实验室检查:脑脊液细胞计数为58×10~6/L(淋巴细胞占优势),蛋白质达1.0g/L,葡萄糖为血液浓度的30%。耐酸杆菌,隐球菌抗原,梅毒抗体及弓形体检查均为阴性。临床及血液学均不支持肿瘤病变;血沉8mm;结核菌素皮内试验阴性(1:10,000结核菌素)。入院后三天未
The bromide partition test is a specific method for the diagnosis of tuberculous meningitis, with high detection rates, especially for the distinction of acute viral lymphocytic meningitis. However, its clinical practicality is rarely evaluated. This article combined with an example of misdiagnosed reports are as follows: Female patients, aged 62, admitted to hospital for anorexia and weight loss four weeks. After hospitalization there was excitement, confusion and dizziness. Clinical examination, see patients with photophobia, papilledema; EEG non-specific abnormalities, CT scan was normal. Laboratory tests: cerebrospinal fluid cell count 58 × 10 ~ 6 / L (lymphocyte predominance), protein 1.0g / L, glucose 30% of the blood concentration. Acid-fast bacilli, cryptococcal antigen, syphilis antibody and toxoplasmosis were all negative. Neither clinical nor hematology supported tumor lesions; erythrocyte sedimentation rate was 8 mm; tuberculin skin test was negative (1: 10,000 tuberculin). Three days after admission