【正文】 ciousness, NO left supraclavicular lymph node enlargement, no icterus, no lower limb edema, no palmar erythema, no spider telangiectasia, no skin pigmentation, no flapping tremor,no capillary distension,no fetor hepaticus.Abdomen:: External appearance: Smooth Abdominal vein distension: Absent Breathing type: hyperventilated Breathing movement: NormalSurgical scar: Absent Discoloration: Absent: No pain Pain with pressure or rebound tenderness: Absent Swelling: Absent Liver: Palpable Gall bladder: Absent, no pain with pressure, negative Murphy sign Spleen: Not palpable Kidney: Not palpable Bladder: Full(distended): Dullness of border of liver: On right, midclavicular line on the 5th ICS(Upper border) of a length of about 9 cm , no percussion pain on the region of the liver or gall bladder Dullness of border of spleen: Left midaxillary line 911th ICS, about 9 cm No shifting dullness, no percussion pain of the costophrenic region.: Borborygmus: Normal No metallic sound5. Others: None特殊檢查(Special Examination)：MRI: Intracranial CT scan shows no change, renal atrophy with multiple stones mainly in bladder, left ureter. There is gall bladder bile duct stone. There is pneumonia with bilateral pleural effusion. Bilateral centrum ovale multiple lacunar white matter changes in atherosclerotic lesions of chronic sinusitisLabs Data:2013/07/28 Csf culture:protein+, wbc 356*10^6/L,Monocyte 85%,cl 119mmol/l,Glucose , protein g/lCSF culture2013/07/31 CSF: RBC18*10^6/L , WBC 220 *10^6/L , Monocyte: 90%, CSF biochemistry : CL 115mmol/L , Glucose mmol/L, Protein , ADA : 6U/L初步診斷(Primary Diagnosis):Intracranial infectionTuberculous meningitis 內(nèi)容總結(jié)