144.2 📚 國考版

144.2.0.1 必背 — Chronic Meningitis 病因

• Infection: TB, Cryptococcus, syphilis, Lyme, Brucella, fungi
• Non-infectious: cancer, sarcoid, autoimmune, drugs

144.2.0.2 必背 — TB Meningitis

• CSF: lymphocytic + protein ↑↑ + glucose ↓
• GeneXpert MTB/RIF
• RIPE × 2 mo + RH × 7-10 mo = 9-12 mo
• + Dexamethasone × 6-8 wks taper (Thwaites)

144.2.0.3 必背 — Cryptococcal Meningitis

• HIV (CD4 < 100), transplant
• India ink + CrAg + culture
• Liposomal AmB + 5-FC × 2 wks → Fluconazole 800 × 8 wks → 200 maintenance ≥ 1 yr
• Therapeutic LP for ↑ ICP (> 25 cm H2O)

144.2.0.4 必背 — Recurrent

• Anatomic CSF leak: S. pneumo
• Mollaret’s: HSV-2
• DIAM: NSAIDs, TMP-SMX, IVIG

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