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重症监护病房中枢神经系统感染管理的进展

Advances in the management of central nervous system infections in the ICU.

作者信息

Ziai Wendy C, Lewin John J

机构信息

Division of Neurosciences Critical Care, Department of Neurology, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.

出版信息

Crit Care Clin. 2006 Oct;22(4):661-94; abstract viii-ix. doi: 10.1016/j.ccc.2006.11.009.

Abstract

This chapter focuses on early aggressive management of common infections of the central nervous system that require monitoring in an ICU setting. These include meningitis, encephalitis, brain and epidural abscess, subdural empyema and ventriculitis. It emphasizes priorities in evaluation and management due to increasing morbidity and mortality as a result of failure to appreciate non-specific symptoms or administer timely therapy. The emergence of organisms resistant to penicillin and cephalosporins has also further complicated the early management of bacterial meningitis. Current antimicrobial guidelines are provided along with discussion of new diagnostic and therapeutic strategies and controversial aspects of management.

摘要

本章重点关注中枢神经系统常见感染的早期积极管理,这些感染需要在重症监护病房环境中进行监测。这些感染包括脑膜炎、脑炎、脑脓肿和硬膜外脓肿、硬膜下积脓和脑室炎。由于未能识别非特异性症状或未及时进行治疗导致发病率和死亡率上升,本章强调了评估和管理的重点。对青霉素和头孢菌素耐药的微生物的出现也使细菌性脑膜炎的早期管理更加复杂。文中提供了当前的抗菌指南,并讨论了新的诊断和治疗策略以及管理方面存在争议的问题。

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