DGI:ZNS-Infektionen/Tuberkulose Meningitis/Diagnostik: Unterschied zwischen den Versionen

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Version vom 17. Juni 2021, 07:52 Uhr

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)

↑ 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
↑ 9. Wilkinson RJ, et al., Tuberculous meningitis. Nat Rev Neurol, 2017; 13(10): 581-598
↑ 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)
↑ 11. in Tuberculosis: Clinical Diagnosis and Management of Tuberculosis, and Measures for Its Prevention and Control. 2011; London
↑ 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
↑ 14. Chin JH, Tuberculous meningitis: Diagnostic and therapeutic challenges. Neurol Clin Pract, 2014; 4(3):199-205
↑ 15. Marais S, et al., Tuberculous meningitis: a uniform case definition for use in clinical research. Lancet Infect Dis, 2010; 10(11): 803-12

[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

[1]

[2]

[3]

[4]

[5]

[6]

[7]

@@ Zeile 26: / Zeile 26: @@
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 <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;"
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-| 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>
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-| 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>
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-| 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>
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-| 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>
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-| 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>
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+|
+|
+|
+|
+|
 |}
 <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>