Gastón I, Muruzábal J, Quesada P, Maraví E
Servicio de Neurología, Hospital Virgen del Camino, Pamplona, Spain.
An Sist Sanit Navar. 2008;31 Suppl 1:99-113.
Infections of the central nervous system are frequent diseases in emergency care. They can have a bacterial, parasitic or viral origin. Initial symptoms can be non-specific, which can complicate and delay diagnosis, hence the extreme importance of all the information that can be obtained through anamnesis and physical exploration, with frequent complementary explorations. In the last hundred years, with the introduction of antibiotic drugs, there has been a significant fall in mortality secondary to meningoencephalitis, but in spite of that they continue to provoke high morbidity and mortality. Other phenomena, such as vaccination campaigns, migratory movements, infection by HIV and other states of immunosuppression, have given rise to important epidemiological changes such as the virtual disappearance of some infections or the appearance of others that rarely existed previously. The list of potential infections of the central nervous system is extensive, which is why in this review we set out, from the clinical, diagnostic and therapeutic point of view, those that are most frequent in our environment and some that, although very infrequent, might require emergency attention due to their severity.
中枢神经系统感染是急诊护理中的常见疾病。它们可能源于细菌、寄生虫或病毒。初始症状可能不具特异性,这会使诊断复杂化并导致延误,因此通过问诊和体格检查获取的所有信息极为重要,同时还经常需要进行辅助检查。在过去的一百年里,随着抗生素药物的引入,因脑膜脑炎导致的死亡率显著下降,但尽管如此,它们仍然会引发高发病率和死亡率。其他现象,如疫苗接种运动、人口迁移、艾滋病毒感染和其他免疫抑制状态,导致了重要的流行病学变化,例如某些感染几乎消失或出现了以前很少见的其他感染。中枢神经系统潜在感染的清单很长,这就是为什么在本综述中,我们从临床、诊断和治疗的角度出发,阐述了我们环境中最常见的那些感染,以及一些虽然非常罕见,但因其严重性可能需要紧急关注的感染。