Case I. 59 years old, male
[History of present illness]
25, April, 1998 High fever (39□Celsius)
26, April, Visited a general practitioner near by with complaint of neck pain.
Hospitalized because of the suspect of meningitis.
Tentative diagnosis was viral (herpes) meningitis, and treated with sobilax.
4, May, No improvement of symptom□and became coma
7, May, Transferred to Medical College Hospital.
Diagnosed as tuberculous meningitis.
(Liquor: ADA 13.2 IU/1, C1 decreased, Glucose decreased, Protein increased)
General conditions worsened, respirator was used.
Started treatment with anti-tuberculosis drug.
Middle, May Paralysis of left facial nerve.
8, June Admitted to our hospital.
JCS□Japanese Coma Scale□ level III-200,
HRZE 5 days, SH 14 days, Then SHRZ had been continued.
Slight improvement, JCS level III-100
Early Nov. High fever, abdominal pain. Candida albicans (+) by blood culture
5, Nov. Died of sepsis and meningitis.
[Laboratory data]
9, June 1998 WBC 5500, (N 75.3%, Eo 3.9%, Mo 5.6%, Lym 14.3% )
RBC 2.59 million, Hb 8.1, Ht 25.9%, MCV 100, MCHC 31.3, Plt 30.3.
TP 5.5, Alb 2.9, BUN 22, Cre 0.5, U-A 4.6, Glu 91, T-bil 0.3,
AST(GOT) 32, ALT (GPT) 48, LDH 268, Alp 148.
Na 134, K 4.1, Cl 102, CRP 1.2mg/dl
Sputum smear (-), culture (-)
Case II 28 years old male
End Dec. 1999 Left chest pain
10, January, 2000 Short of breath.
Chest radiography at near general practitioner.
Abnormal shadow was pointed out.
18, January Hospitalized to Fukujyuji Hospital
(Tuberculin skin test) 10*10/30*20
(Punctured fluid)
yellow, slightly turbid, serous.
Protein 4.74 g/dl, glucose 92 mg/dl, LDH 553 IU/1, Amilase 31□ADA 112 IU/□
□□□□Lymph94□□Mesothelium □cells4□□Neutro2%
□□□□CEA9.7ng/ml
□□□□Pleural effusion smear for AFB(-), culture for AFB(-)
26, January Started anti-tuberculosis treatment with HRE.
