原发性钩端螺旋体病。
Primary neuroleptospirosis.
作者信息
Panicker J N, Mammachan R, Jayakumar R V
机构信息
Department of Medicine, Medical College, Thiruvananthapuram, Kerala, India.
出版信息
Postgrad Med J. 2001 Sep;77(911):589-90. doi: 10.1136/pmj.77.911.589.
Leptospirosis is an important zoonosis of worldwide distribution. It is uncommon for leptospirosis to present as a primary neurological disease. In this study of patients who presented with an acute neurological disease, and who were subsequently found to have leptospirosis, aseptic meningitis was the commonest manifestation. The other presentations were myeloradiculopathy, myelopathy, Guillain-Barré syndrome-like presentation, meningoencephalitis, intracerebral bleed, cerebellar dysfunction, iridocyclitis, and tremor/rigidity. Treatment consists of antibiotics, crystalline penicillin being the drug of choice, which reduces the course of illness if given early. The role of steroids is controversial. The prognosis after primary neuroleptospirosis is generally good but altered sensorium and seizures herald a worse prognosis.
钩端螺旋体病是一种分布于全球的重要人畜共患病。钩端螺旋体病以原发性神经疾病形式出现的情况并不常见。在这项针对出现急性神经疾病且随后被发现患有钩端螺旋体病的患者的研究中，无菌性脑膜炎是最常见的表现。其他表现包括脊髓神经根病、脊髓病、吉兰 - 巴雷综合征样表现、脑膜脑炎、脑出血、小脑功能障碍、虹膜睫状体炎以及震颤/强直。治疗包括使用抗生素，首选药物是结晶青霉素，如果早期给药可缩短病程。类固醇的作用存在争议。原发性神经钩端螺旋体病后的预后一般良好，但意识改变和癫痫预示着预后较差。
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