DGI:ZNS-Infektionen/Tuberkulose Meningitis/Diagnostik: Difference between revisions

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======<span class="mw-headline" id="Mikrobiologie:" style="box-sizing: inherit;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Mikrobiologie''':'''</span></span>======
======<span class="mw-headline" id="Mikrobiologie:" style="box-sizing: inherit;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Mikrobiologie''':'''</span></span>======
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Liquor</span>
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Liquor</span>
{| class="wikitable sortable mw-collapsible filterable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: \&quot;Open Sans\&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;&quot;}" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(255, 255, 255); font-size: 14px; color: rgb(51, 51, 51); font-family: &quot;Open Sans&quot;, Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border: none;"
{| class="wikitable  
|+
|+
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |
|-
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Normal</span>'''
!Normal
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Virale Meningitis</span>'''
!Virale Meningitis
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Bakterielle Meningitis</span>'''
!Bakterielle Meningitis
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |'''<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">Tuberkulöse Meningitis</span>'''
!Tuberkulöse Meningitis
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|-
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Aspekt</span>
!Aspekt
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">klar</span>
|klar
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">klar</span>
|klar
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">trüb</span>
|trüb
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">klar-trüb</span>
|klar-trüb
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|-
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Druck</span>
!Druck (cm H<sub>2</sub>O)
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">(cm H<sub data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11px; line-height: 1; position: relative; vertical-align: baseline; bottom: -0.25em;&quot;}" style="box-sizing: inherit; font-size: 11px; line-height: 1; position: relative; vertical-align: baseline; bottom: -0.25em;">2</sub>O)</span>
|5-12
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">5-12</span>
|Normal oder
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Normal oder</span> <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Symbol;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Symbol;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;">­</span></span>
|>20
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">> 20</span>
|Normal oder
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Normal oder</span> <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Symbol;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Symbol;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;">­</span></span>
|-
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
!Leukozyten(x 10<sup>6</sup>/l)
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Leukozytenzahl</span>
|1-4
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">(x 10<sup data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11px; line-height: 1; position: relative; vertical-align: baseline; top: -0.5em;&quot;}" style="box-sizing: inherit; font-size: 11px; line-height: 1; position: relative; vertical-align: baseline; top: -0.5em;">6</sup>/l)</span>
|< 1000 Lymphozyten
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">1-4</span>
|> 1000
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 1000</span>
(> 70% Neutrophile)
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Lymphozyten</span>
|< 1000
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">> 1000</span>
(Mono- und Lymphozyten)
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">(> 70% Neutrophile)</span>
|-
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 1000</span>
!Glukose (% des Serumwertes)
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">(Mono- und Lymphozyten)</span>
|50-80%
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|50-80%
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Glukosegehalt</span>
|
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">(% des Serumwertes)</span>
|
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">50-80%</span>
|
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">50-80%</span>
|
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 40%</span>
|
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 40%</span>
|
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Eiweiß (mg/l)</span>
|
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">150-500</span>
|
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Normal oder</span> <span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Symbol;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Symbol;"><span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;">­</span></span>
|
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">>> 500</span>
|
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">>> 500</span>
|
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Laktat (mmol/l)</span>
|
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 1,6</span>
|
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">< 1,6</span>
|
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">> 3,5</span>
|
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">> 1,6</span>
|
|- data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit;&quot;}" style="box-sizing: inherit;"
|
| style="width:80.5pt;" width="107" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:80.5pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Direktpräparat</span>
|
| style="width:53.95pt;" width="72" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:53.95pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Negativ</span>
|
| style="width:92.1pt;" width="123" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:92.1pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">Negativ</span>
|
| style="width:114.25pt;" width="152" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:114.25pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">80% positiv</span>
|
| style="width:112pt;" width="149" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:112pt;&quot;}" |<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-size: 11pt; font-family: Arial, sans-serif;">35% positiv</span>
|
|
|
|
|
|
|}
|}
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Tabelle 1: Differentialdiagnostische Liquoranalyse</span>
<span class="ve-pasteProtect" data-ve-attributes="{&quot;style&quot;:&quot;box-sizing: inherit; font-family: Arial, sans-serif;&quot;}" style="box-sizing: inherit; font-family: Arial, sans-serif;">Tabelle 1: Differentialdiagnostische Liquoranalyse</span>

Revision as of 07:52, 17 June 2021

Diagnose

Anamnese

·        Chronischer Husten? Gewichtsverlust? B-Symptomatik?

·        Reiseanamnese

·        Herkunftsland

·        Frühere Tbc-Diagnose oder Therapie, Tbc-Fall im sozialen Umfeld?

·        Risikofaktoren:

  • Malnutrition
  • Immunsuppression
  • Andere Infektionen, v.a. HIV (Bei Erstdiagnose Tbc immer HIV Test)
  • Chronischer Alkoholabusus
Radiologie:

·        Röntgen-Thorax

·        Sensitivität MRT > CT für pathogene Tbc-Assoziation

·        Ggf. SPECT, PET

Mikrobiologie:

Liquor

Normal Virale Meningitis Bakterielle Meningitis Tuberkulöse Meningitis
Aspekt klar klar trüb klar-trüb
Druck (cm H2O) 5-12 Normal oder  >20 Normal oder 
Leukozyten(x 106/l) 1-4 < 1000 Lymphozyten > 1000

(> 70% Neutrophile)

< 1000

(Mono- und Lymphozyten)

Glukose (% des Serumwertes) 50-80% 50-80%

Tabelle 1: Differentialdiagnostische Liquoranalyse

Goldstandard: Kultur auf Tbc (sensitiver als Mikroskopie, ist in bis zu 50-70% positiv). Dauer der Kultur bis 8 (-12) Wochen [8[1][2][3][4][5]-12, 14[6], 15[7]].

Xpert MTB/Rif, PCR zur Bestimmung von Tbc sowie Rifampicin-Resistenz, welches ein Hinweis für eine MDR-Tbc ist. Die Verlässlichkeit eines resistenten Ergebnisses (positiv prädiktiver Wert) ist abhängig von der Häufigkeit der Resistenz in der untersuchten Bevölkerung. Liegt die MDR-Rate, wie in Deutschland, unter 5%, sinkt der positiv prädiktive Wert auf unter 70% [1].

Differentialdiagnose

  • Andere bakterielle Meningitiden (Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, Listeria monocytogenes, Streptococcus, agalactiae), Neuroborreliose
  • Pilze: Candida spp., Aspergillus spp., Kryptokokkus spp.
  • Parasiten: Echinokokkus spp., Toxoplasma
  • Nicht-infektiös: Sarkoidose, tumorös (Meningiosis carcinomatosa)
  1. ↑ 8.        Schaberg T, et al., Tuberculosis Guideline for Adults - Guideline for Diagnosis and Treatment of Tuberculosis including LTBI Testing and Treatment of the German Central Committee (DZK) and the German Respiratory Society (DGP). Pneumologie 2017; 71(6): 325-397
  2. ↑ 9.        Wilkinson RJ, et al., Tuberculous meningitis. Nat Rev Neurol, 2017; 13(10): 581-598
  3. ↑ 10.        Ducomble T, et al., The burden of extrapulmonary and meningitis tuberculosis: an investigation of national surveillance data, Germany, 2002 to 2009. Euro Surveill, 2013; 18(12)
  4. ↑ 11.         in Tuberculosis: Clinical Diagnosis and Management of Tuberculosis, and Measures for Its Prevention and Control. 2011; London
  5. ↑ 12.        Thwaites G, et al., British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect, 2009; 59(3): 167-87
  6. ↑ 14.         Chin JH, Tuberculous meningitis: Diagnostic and therapeutic challenges. Neurol Clin Pract, 2014; 4(3):199-205
  7. ↑ 15.        Marais S, et al., Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis, 2010; 10(11): 803-12
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