Calfee D P, Wispelwey B
Department of Medicine, University of Virginia School of Medicine, Charlottesville 22908, USA.
Semin Neurol. 2000;20(3):353-60. doi: 10.1055/s-2000-9397.
The epidemiology of brain abscess has changed with the increasing incidence of this infection in immunocompromised patients, particularly solid organ and bone marrow transplant recipients, and the decreasing incidence of brain abscess related to sinusitis and otitis. A number of new neuroimaging modalities, including single photon emission computed tomography, positron emission tomography, perfusion magnetic resonance imaging, and magnetic resonance spectroscopy, provide an initial noninvasive approach to diagnosis. The recommendations for the management of intracranial mass lesions in human immunodeficiency virus-infected individuals has changed as the incidence of toxoplasmic encephalitis has decreased with the use of trimethoprim-sulfamethoxazole prophylaxis. The epidemiology, pathogenesis, microbiology, clinical presentation, diagnosis, treatment and prognosis of brain abscess in the beginning of the 21 st century are provided in this review.
随着免疫功能低下患者(尤其是实体器官和骨髓移植受者)中这种感染发病率的增加,以及与鼻窦炎和中耳炎相关的脑脓肿发病率的降低,脑脓肿的流行病学已发生变化。包括单光子发射计算机断层扫描、正电子发射断层扫描、灌注磁共振成像和磁共振波谱在内的一些新的神经影像学方法提供了初步的非侵入性诊断方法。随着甲氧苄啶 - 磺胺甲恶唑预防性用药使弓形虫性脑炎的发病率降低,人类免疫缺陷病毒感染个体颅内占位性病变的管理建议也发生了变化。本文综述了21世纪初脑脓肿的流行病学、发病机制、微生物学、临床表现、诊断、治疗及预后。