Greenberg Benjamin M
Johns Hopkins School of Medicine, Johns Hopkins Encephalitis Center, 600 North Wolfe Street, Baltimore, MD 21287, USA.
Semin Neurol. 2008 Nov;28(5):682-9. doi: 10.1055/s-0028-1105976. Epub 2008 Dec 29.
Infections of the central nervous system are a frequent cause for admission to the intensive care unit (ICU). These infections can be the reason for presentation to a hospital or a complication of an injury or surgical procedure. Diagnosing these infections can be very challenging, given the relative paucity of tests with high sensitivity and specificity. Regardless, identifying and treating the underlying cause remains the primary objective in each of these cases, but management of complications is the most common reason for ICU admission. Frequent complications include increased intracranial pressure, stroke, coma, and status epilepticus. Although the underlying infection often causes harm, the immune response to the agent and ensuing complications are often responsible for greater damage to the host. Even if the underlying infectious agent does not have a specific therapy, identifying it is important for limiting unnecessary testing. When certain infections are suspected, such as bacterial meningitis or viral encephalitis, empiric therapy should be initiated immediately. Outcomes for these conditions are linked to how quickly appropriate therapies are initiated.
中枢神经系统感染是入住重症监护病房（ICU）的常见原因。这些感染可能是患者前往医院就诊的原因，也可能是受伤或外科手术的并发症。鉴于高灵敏度和特异性检测相对较少，诊断这些感染可能极具挑战性。尽管如此，识别并治疗潜在病因仍是每例此类病例的首要目标，但并发症的处理是入住ICU最常见的原因。常见并发症包括颅内压升高、中风、昏迷和癫痫持续状态。虽然潜在感染通常会造成损害，但对病原体的免疫反应及随之而来的并发症往往对宿主造成更大损伤。即使潜在感染病原体没有特定疗法，识别它对于限制不必要的检测也很重要。当怀疑某些感染时，如细菌性脑膜炎或病毒性脑炎，应立即开始经验性治疗。这些病症的预后与开始适当治疗的速度有关。
