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肺炎支原体中枢神经系统感染

Mycoplasma pneumoniae central nervous system infections.

作者信息

Daxboeck Florian

机构信息

Clinical Institute for Hygiene and Medical Microbiology, Division of Hospital Hygiene, Medical University Vienna, Vienna General Hospital, Vienna, Austria.

出版信息

Curr Opin Neurol. 2006 Aug;19(4):374-8. doi: 10.1097/01.wco.0000236617.04958.60.

Abstract

PURPOSE OF REVIEW

Mycoplasma pneumoniae is associated with a wide range of central nervous system diseases, most importantly with childhood encephalitis. This review summarizes and discusses recent findings in the field of M. pneumoniae central nervous system infections in context with previously published findings, with reference to clinical spectrum, pathogenesis, diagnosis, and treatment.

RECENT FINDINGS

Further insight into the pathogenesis has been provided by studies on cytokine production and autoantibody formation. Some new manifestations have been described (e.g. Kluver-Bucy syndrome, intracranial hypertension). Anecdotal descriptions on the association of M. pneumoniae with uncommon neurologic diseases remain to be confirmed by additional reports, however, especially when aetiologic diagnosis relied exclusively on serology. New knowledge on treatment options targeting the immune system has been provided by isolated reports. Recent diagnostic advances refer to general methods (polymerase chain reaction, serology), without specific reference to neurologic disease.

SUMMARY

M. pneumoniae must be considered as causative agent of various neurologic diseases. The recent literature shows, however, that the clinical spectrum of M. pneumoniae central nervous system disease is still not well defined. In addition, the main future challenges are the investigation of the pathogenesis of M. pneumoniae central nervous system disease and the establishment of therapeutic approaches.

摘要

综述目的

肺炎支原体与多种中枢神经系统疾病相关,最重要的是与儿童脑炎有关。本综述结合先前发表的研究结果,从临床谱、发病机制、诊断和治疗等方面总结并讨论了肺炎支原体中枢神经系统感染领域的最新研究发现。

最新研究发现

关于细胞因子产生和自身抗体形成的研究进一步深入了解了发病机制。已描述了一些新的表现(如克-布综合征、颅内高压)。然而,关于肺炎支原体与罕见神经系统疾病关联的个案描述仍有待更多报告证实,尤其是当病因诊断仅依赖血清学检查时。个别报告提供了针对免疫系统的治疗选择的新知识。近期的诊断进展涉及一般方法(聚合酶链反应、血清学),未特别提及神经系统疾病。

总结

肺炎支原体必须被视为各种神经系统疾病的病原体。然而,近期文献表明,肺炎支原体中枢神经系统疾病的临床谱仍未明确界定。此外,未来的主要挑战是研究肺炎支原体中枢神经系统疾病的发病机制并建立治疗方法。

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