儿科英文：化脓性脑膜炎Bacterialmeningitis导论.ppt

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Laboratory Findings Peripheral hemogram Total WBC count 20×109/L ～40×109/L WBC Decreased WBC count at severe infection Leukocyte differential count 80%～90% Neutrophils Laboratory Findings Rout examination of cerebrospinal fluid (CSF) Increased pressure of cerebrospinal fluid Cloudiness Evident Increased total WBC count (1000×109/L) Evident Increased neutrophils in leukocyte differential count Evident Decreased glucose (1.1mmol/l) Evident Increased protein level Decreased or normal chloridate CSF film preparation or cultivation : positive result Laboratory Findings Especial examination of CSF Specific bacterial antigen test Countercurrent immuno-electrophoresis Latex agglutination Immunofluorescent test Neisseria meningitidis (meningococcus) Haemophilus influenzae Streptococcus pneumoniae ( pneumococcus) Group B streptococcus Laboratory Findings Especial examination of CSF Other test of CSF LDH Lactic acid CRP TNF and Ig Neuron specific enolase (NSE) Laboratory Findings Other bacterial test Blood cultivation Film preparation of skin petechiae and purpura Secretion culture of local lesion Imageology examination Diagnosis Diagnostic methods A careful evaluation of history A careful evaluation of infant’s signs and symptoms A careful evaluation of information on longitudinal changes in vital signs and laboratory indicators Rout examination of cerebrospinal fluid (CSF) Differential diagnosis Clinical manifestation of bacterial meningitis is similar to clinical manifestation of viral, tuberculous , fungal and aseptic meningitis. Differentiation of these disorders depends upon careful examination of cerebrospinal fluid obtained by lumbar puncture and additional immunologic, roentgenographic, and isotope studies. Characteristics of CSF on common disease in CNS PM TM VW FM TE Pressure ↑ ↑