結核性髄膜炎
今日のヘエーは
tuberculous meningitis 診断について
2010年の論文でも 診断基準がないことが問題視されていて
ようやくその基準をつくるためのスタディーをするための診断基準が
決まりました 的なレベル。
そんな中で見つけたのは
１、7日より長い前駆症状
２、眼底検査での視神経萎縮
３、局所神経症状
４、不随意運動（とくに小児）
５、髄液多核球が50％以下
1つでもあれば感度がとても高く、3つ以上あれば特異度がとても高い
Kumar R, Singh SN, Kohli N : A diagnostic rule for
tuberculous meningitis. Arch Dis Child 1999 ; 81 :
221－224.
で述べられているのは小児の話だが1項目なら 感度98.4％
3項目なら特異度 98.3％と書いてある。
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