Polymorphonuclear CSF Pleocytosis during the Treatment of ?Tuberculous Meningitis

J Korean Neurol Assoc > Volume 13(2); 1995 > Article

Journal of the Korean Neurological Association 1995;13(2): 305-310.

결핵성 뇌막염 치료중 발생한 뇌척수액의 다형핵구 세포증가

유경무, 유봉구, 윤성민, 김광수

고신대학교 신경과

Polymorphonuclear CSF Pleocytosis during the Treatment of ?Tuberculous Meningitis

Kyung Mu Yoo, M.D., Bon Goo Yoo, M.D., Sung Min Yoon, M.D., Kwang Soo Kim, M.D.

Department of Neurology, Kosin Medical College

Abstract

Among 73 patients with possible and definite tuberculous meningitis, 14 cases showed a sudden unexpected polymorphonuclear (PMN) CSF pleocytosis during treatment. Patients with superimposed bacterial meningitis were excluded. Eleven patients(15. 1%) matched inclusion criteria. The intervals between the onset of the treatment and the onset of the PMN CSF pleocytosis were 7-54 days(mean 17.2+ 14.4 days). The mean duration of PMN CSF pleocytosis was 14.2+12.4 days. A PMN CSF pleocytosis may develop occasionally weeks or months after the start of the treatment for tuberculous meningitis. Though the cause is uncertain, we suggest that probably its cause is superimposed acute meningeal inflanunation by the release of Mycobacterium from tuberculomas or.delayed Jarisch-Herxheimer reaction.