ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG BỆNH LAO MÀNG NÃO Ở NGƯỜI LỚN NHIỄM HIV/AIDS

Abstract

Objective: Describe the clinical and paraclinical characteristics of tuberculosis meningitis in adults infected with HIV/AIDS. Subjects & methods: cross-sectional description, retrospective combined with prospective on 56 HIV/AIDS patients diagnosed with tuberculosis meningitis treated at the National Hospital of Tropical Diseases and Central Lung Hospital since January /2011 to July 2016. Results: age group 30 - 40 (66.1%), male (86%), fever (80.4%), headache (94.5%), nausea and vomiting (80.4%), stiff neck 76.4%, weight loss (66.1%), mental disorders 55.4%, consciousness from lethargy to coma 55.4%, circular muscle disorders 32.1%, seizures 14.3% and focal nerve paralysis (from 1.8 - 8.9%). Cerebrospinal fluid: yellow (64.3%), increased pressure (90.9%). Average protein concentration is 2.38 ± 1.85 g (increase per 1g is 86.8%), sugar is reduced (89.3%). The average cell count was 433 ± 429 cells (> 100 cells/ml is 88.6%). Culture results (+) were 67.6% and PCR results (+) were 90.7%. Imaging diagnosis: 54% had lesions on X-ray, of which 51.9% had nodular lesions, 14.8% pleural effusion, and 11.1% miliary tuberculosis. On brain MRI scans, 83.9% had abnormalities, including cerebral infarction (30.8%), cerebral edema (38.5%), and ventricular dilatation (26.9%). Blood test: 78.6% have severe immunodeficiency CD4 below 200.