TUBERCULOUS MENINGITIS IN PATIENTS WITH AND WITHOUT HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION
TUBERCULOUS MENINGITIS IN PATIENTS WITH AND WITHOUT HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION
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DOI：
10.1016/0002-9343(92)90579-z
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发表时间：
1992-11-01
影响因子：
5.9
通讯作者：
LARSEN, RA
中科院分区：
文献类型：
--
作者：
DUBE, MP;HOLTOM, PD;LARSEN, RA
目的：描述有和无人类免疫缺陷病毒（HIV）感染的患者中培养证实的结核分枝杆菌引起的脑膜炎的症状、体征、实验室检查结果和结局。设计：回顾性病历回顾。地点：美国城市公立综合医院。患者：15例有和16例无HIV感染的患者。测量：人口统计学、症状、体格检查结果、血清钠、全血细胞计数、CD 4+细胞计数、脑脊液结果、影像学数据和住院死亡率。两组的症状、体征、胸片表现、脑脊液细胞计数和化学成分以及死亡率相似（p = NS）。HIV感染患者的中位CD 4+细胞计数较低（中位99/mm 3，范围7 - 251，而非HIV感染患者为384/mm 3，范围171 - 724，p = 0.007）。脑内肿块性病变在HIV感染组中更为常见（60%对未感染组的14%，p = 0.01），尽管肿块的存在与局灶性神经功能缺损、意识水平改变或死亡率无关。除了HIV感染者脑内肿块病变的发生率增加外，HIV感染似乎对结核性脑膜炎的发现和住院死亡率几乎没有影响。
OBJECTIVE: To characterize the symptoms, signs, laboratory findings, and outcome of culture-proven meningitis due to Mycobacterium tuberculosis in patients with and without human immunodeficiency virus (HIV) infection.DESIGN: Retrospective chart review.SETTING: Urban public general hospital in the United States.PATIENTS: Fifteen patients with and 16 without HIV infection.MEASUREMENTS: Demographics, symptoms, physical exam findings, serum sodium, complete blood cell count, CD4+ cell count, cerebrospinal fluid findings, imaging data, and in-hospital mortality.MAIN RESULTS: Symptoms, signs, chest radiograph appearance, cerebrospinal fluid cell counts and chemistries, and mortality were similar in both groups (p = NS). Median CD4+ cell counts were lower in HIV-infected patients (median 99/mm3, range 7 to 251, versus 384/mm3, range 171 to 724 in those without HIV infection, p = 0.007). Intracerebral mass lesions were more common in the HIV-infected group (60% versus 14% in the uninfected group, p = 0.01), although the presence of a mass did not correlate with focal neurologic deficits, altered level of consciousness, or mortality.CONCLUSION: With the exception of an increased incidence of intracerebral mass lesions in HIV-infected individuals, HIV infection appears to have little impact on the findings and in-hospital mortality of tuberculous meningitis.