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Clinical Observations on Tuberculous Meningitis in Childhood.

Journal of the Korean Pediatric Society 1981;24(8):723-734.
Published online August 15, 1981.
Clinical Observations on Tuberculous Meningitis in Childhood.
Seung Joon Park, Young Soo Yoon, You Nam Kim, Ki Bok Kim
Department of Pediatrics, Kwanju Christian Hospital, Korea.
小兒 結核性 腦膜炎의 臨床的 檢討
朴勝準, 尹英秀, 尹攸南, 金基福
光州基督病院 小兒科
Abstract
A clinical study was carried out on patients with tuberculous meningitis who were admitted to the Department of Pediatrics, Kwangju Christian Hospital during a 9 year period from January, 1971 to December, 1979. The following results were obtained. 1) About 3/4 of all cases were under the age of 6, the majority being between the age of one and three. The male-to-female ratio was 1.3:1. 2) Seasonal incidence was in the order of spring, summer, winter and autumn, but no sign ificant differences were noted. 3) A family history of tuberculosis was found in 41.5%, usually in one of the parents. 4) A history of B.C.G. vaccination was found in 16.7% of tuberculous meningitis cases. The tuberculin test was positive in 28.9%. 5) The most frequent symptoms on admission were vomiting, fever, convulsion and headache, in that order. 6) The major neurologic findings were unconsciousness(34.0%), neck stiffness(76.4%), and positive Kernig's sign(63.2%). 7) Leukocytes in the C.S.F. on admission were generally elevated, but below the range of 500/mm3 in 74.5% of cases, and the mean count was 278.7/mm3 with 66.7% lymphocytes. Mean protein level in the C.S.F. was 162.5mg/dl, and 94.3% of all cases were over 50mg/dl. Sugar in the C.S.F. was definitely reduced to less than 120 mEq/L in 78.3%, with the mean level being 112.8mEq/L. 8) Chest X-ray revealed tuberculous lesions in 69.8% and miliary tuberculosis was found in 36.8% of cases. 9) The highest mortality was seen in young infants. Among 26 patients of clinical stage I on admission, 21(80.3%) recovered, and 35(79.5%) of 44 patients of stage II recovered, whereas only 13(36.1%) out of 36 patients of stage III were cured. Over-all mortality rate was 5.7% of those followed.
Key Words: Tuberculous Meningitis in Childhood, Clinical Observations


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