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題 名 | Tuberculous Meningitis in a Filipino Maid=一菲傭之結核性腦膜炎 |
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作 者 | 許昭俊; 袁瑞昱; 盧章智; 鍾啟禮; 許昭禹; | 書刊名 | 臺灣醫學會雜誌 |
卷 期 | 98:11 1999.11[民88.11] |
頁 次 | 頁783-786 |
分類號 | 415.9313 |
關鍵詞 | 結核性腦膜炎; Tuberculosis; Tuberculous meningitis; Foreign worker; |
語 文 | 英文(English) |
英文摘要 | Tuberculous meningitis, while not uncommon in Taiwan, has not been reported among foreign workers. We report the first case of tuberculous meningitis in a 37-year-old Filipino maid in Taiwan, who presented with headache, fever and vomiting. She had been well before this episode and the small screening films of the chest radiograph obtained on her arrival in Taiwan 15 months previously, and every 6 months thereafter showed no evidence of tuberculosis. The suspicion of tuberculous meningitis was delayed until disturbance of consciousness manifested and a standard chest radiograph showed a diffuse miliary pattern in both lung fields. A cerebrospinal fluid sample that was sent for a polymerase chain reaction-based assay specific for Mycobacterium tuberculosis showed a positive result. The patient recovered with sequelae of mildly incoherent speech and urinary incontinence after antituberculous medication and short-course steroid treatment. Clinicians should be aware of the possibility of tuberculous meningitis in foreign workers with complaints of fever and headache. Because high-quality chest radiographs are a prerequisite for early detection of pulmonary tuberculosis, we recommend that standard posterior-anterior chest radiographs should be obtained as part of the routine health examination for foreign workers. |
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