Schmutzhard E, Pfausler B
Neurologische Intensivstation, Universitätsklinik für Neurologie, Anichstrasse 35, 6020, Innsbruck, Austria.
Nervenarzt. 2008 Sep;79 Suppl 2:93-108; quiz 109. doi: 10.1007/s00115-008-2462-x.
Infections of the central nervous system (CNS) can be caused by a variety of pathogens, depending on whether the number and function of T-cells or monocytes are impaired (as in HIV patients) or whether the number and function of polymorphonuclear granulocytes are reduced or impaired, as typically seen in patients on immunosuppressive therapy, post transplantation, etc.. The first part of the chapter deals with CNS infections associated with reduced or abnormal T-cell (or monocytic) function and number, mainly seen in HIV patients, such as cerebral toxoplasmosis, CNS cryptococcosis, cytomegalovirus encephalitis, and progressive multifocal leukoencephalopathy. The clinical presentation, diagnostic procedures, as well as therapeutic and prophylactic management of these diseases are described in detail. The second part of the chapter deals with diseases usually seen in patients with impaired or reduced number and function of polymorphonuclear granulocytes. Such CNS infections are frequently caused by viral, bacterial, or fungal pathogens and are described in their clinical presentation, their diagnostic procedures and the best possible therapeutic and prophylactic management.
中枢神经系统(CNS)感染可由多种病原体引起,这取决于T细胞或单核细胞的数量和功能是否受损(如在艾滋病患者中),或者多形核粒细胞的数量和功能是否减少或受损,这在接受免疫抑制治疗、移植后等患者中较为常见。本章的第一部分讨论与T细胞(或单核细胞)功能和数量减少或异常相关的中枢神经系统感染,主要见于艾滋病患者,如脑弓形虫病、中枢神经系统隐球菌病、巨细胞病毒性脑炎和进行性多灶性白质脑病。详细描述了这些疾病的临床表现、诊断程序以及治疗和预防管理。本章的第二部分讨论通常见于多形核粒细胞数量和功能受损或减少的患者的疾病。此类中枢神经系统感染常由病毒、细菌或真菌病原体引起,并描述了其临床表现、诊断程序以及最佳的治疗和预防管理。