7岁女孩，低热半个月，消瘦，轻咳。查体:体温380C，营养差，右背下部听诊呼吸音减低，下肢有结节性红斑。接种过卡介苗，PPD试验强阳性。如果此患儿出现头痛、呕吐，脑膜刺激征阳性，应首先进行的检査是

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