The Clinical Characteristics Analysis Of Three Meningitis And The Value Of Latex Agglutination Test In Early Diagnosis Of Cryptococcal Meningitis

Objective:To summarize the clinical characteristics of cryptococcal meningitis(CM), tuberculous meningitis(TBM) and purulent meningitis (PM),and studing the value of Latex Agglutination Test (LAT) in early diagnosis of cryptococcal meningitis.Methods:Form April 2013 to December 2015,the clinical data and cerebrospinal fluid (CSF) latex agglutination test results of 25 cases of cryptococcal meningitis,25 cases in the diagnosis of tuberculous meningitis (TBM)and 25 patients who was diagnosed to purulent meningitis(PM) were retrospectively analyzed.Results:1.Case history:Pigeons contact history or with immunocompromised patients prone to CM; 2.Occupation:Farmers were significantly higher than the proportion of other occupation in three groups, but no statistically significant difference between the three groups; 3. Temperature:temperature in three groups of meningitis patients exist significant difference, temperature of patients in group with PM was significantly higher than that of the other two groups, which more than 39.0 degrees, but no statistical significance were shwon between the groups of CM and TBM; 4.Cerebrospinal fluid pressure:three groups of patients with meningitis CSF pressure exists significant difference, cryptococcal meningitis in patients with cerebrospinal fluid pressure than the other two groups increased more obvious, and 56.0% of which were more than 300mmH2O, but the group between PM and TBM without statistical significance; 5. Examination of cerebrospinal fluid:Three groups of patients with meningitis cerebrospinal fluid have statistical differences of nucleus cells, PM group was significantly higher than that in CM group and TBM group increased, which of 32.0% reached more than 1000 X 106/L, but no significant difference between the group CM group and TBM group;also,there was a statistically significant difference between CSF protein and chlorine in three groups, TBM group protein compared with CM group and PM group there were 92.0% of TBMs increased to more than 1000-2000mg/L, but a lower chloride,20.0% less than 102.0mmol/l, but no difference significant was shown between the group with the PM group and CM group.Glucose levels had no significant difference in three groups; 5. Cryptococcal latex agglutination test admission first CSF positive detection rate was 94.4% and total positive rate was 100%, the positive rate was significantly better than the ink stain and fungal culture, with 100% sensitivity, specificity of 95.5%.Conclusion:1.The early clinical symptoms and signs of CM were similar to other meningitis, which may easy to misdiagnosis in the fisrt time.2.The temperature of PM group was significantly higher than the other two groups which up to 39.0℃; 3.CM in cerebrospinal fluid of patients with pressure increased significantly, often up to more than 300mmH2O, nuclear cell number increased to 200 X 106/L following, not as PM increased significantly.Examination of cerebrospinal fluid glucose and chloride decreased,Chloride decreased a levels of 102-120mmol/l, cerebrospinal fluid protein increased, but more in the following 1000mg/L, but the degree of chloride reduction and protein level is not as obvious as TBM; 4.Latex agglutination test is highly sensitive and highly specific in the diagnosis of meningitis. It can be used as an effective method for early diagnosis of CM.