The authors studied 143 cases of tuberculous meningitis, selecting the patients in two groups: the first group included those cases in which the B.K. was seen by the direct examination or by inoculation of guinea pig; the second group included cases in which suggestive changes in the spinal fluid were present in association with the clinical picture and presence of specific lesion. The spinal fluid examination included pressure values, aspect, color, fibrin net, cell count (total and specific), total proteins, globulin reactions, chlorides and glucose values, colloidal test, Wassermann test, Eagle test, Steinfeld test, complement reaction for cysticercus and direct bacterioscopic examination. The examination of the spinal fluid acquires great value on the diagnosis of tuberculous meningitis due to the difficulty in identifying the B.K. by direct examination. The authors found an average characteristic spinal fluid picture in the tuberculous meningitis: pressure, 37 cm of water, with the patient in lateral decubitus; opalescent in aspect, colorless, with fibrin net; 242 cells per mm³ (77.85 per cent of lymphocytes, 4 per cent of polymorphonuclear leucocytes, 2 per cent of plasma cells, 16 per cent of granulocytes neutro* phyls, 0.10 per cent of eosinophyls, 0.05 per cent of basophyls) ; total proteins 1.16 gm. per liter; Pandy test +++; Weichbrodt test +; Nonne test ++; benjoim colloidal test 00000.22222.22200.0; Takata-Ara test positive; red type of curve; chlorides 6,67 gm. per liter; glucose 0,34 gm. per liter; Wassermann test negative; B.K. present (direct examination or inoculation). Differential diagnosis is made with syphilitic meningitis, cerebral cysti-cercosis, virus meningitis, meningitis that occurs in post-operative period in neurological patients and subarachnoid hemorrhage.
